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I 



Page 

The Nursing of People of Moderate Means from the Viewpoint of 

THE Physician Franklin W. Barrows, M.D. i 

Another View of Hospital Work Among the Poor A R. N. 6 

Battle Harbour Hospital in the Frozen North Fe/i'x J. Koch ii 

Care of Matted Hair 14 

The Value of Parliamentary Law on the Floor Cora Welles Trow 15 

A Practical Point 17 

Infant Feeding Myer Solis-Cohen, A.B., M.D. 18 

Little Raymond BeriBPa E. Merrill 22 

P)A( teriology Clara Foster, R.N. 23 

Pe/^^ons for Army Nurses Anita Newcomb McGee 2^ 

QuEsiioNS OF Nurses' Examining Board of the District of Columbia 31 

Christmas Under Quarantine Lillian M. Squire 33 

Department of Army Nursing • Dita H. Kinney 35 

Editorially Speaking 37 

In the Nursing World 41 

Book Reviews 50 

The Editor's Letter-Box 54 

New Remedies and Appliances 62 

The Publisher's Desk 70 



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Cf)e Craineli jlurse ann 



VOL. XL. 



NEW YORK. JANUARY. 1908 



NO. 1 



C!)e JBturstng of people of jHolierate jHeans 
jfrom tf)e ¥^ietopoint of t|)e ^i)^fiictan 



FRANKLIN W. BARROWS, M. D., BUFFALO, N. Y. 



YUU have conferred a privilege upon 
me by your friendly invitation to 
speak to you to-day, and you have thrust 
a responsibility upon me by requiring me 
to represent the views of the profession 
to which I belong. I thank you for the 
privilege. At this moment it remains to 
be seen whether you will have cause to 
thank me for assuming the responsibility. 
As usual, the nurse and the doctor 
have met together to consult about the 
patient, and, as usual, the patient is to 
have nothing to say about it to-day, al- 
though he may have his say later. There 
are more than two sides to every question 
— this has three. And while you and I 
are expressing our concern for the pa- 
tient we know very well that beneath it 
all is a deep and strong undercurrent of 
concern for ourselves and our kind. This 
is right. It is the thought that inspired 
the counsel, "To thine own self be true, 
and it must follow, as the night the day, 
thou canst not then be false to any man." 
If we tackle the problem before us in this 
spirit we will find that in the last analysis 
the interests of the patient, the nurse and 

♦Read before llio N(iv York State Association of 
Tub Tkainhd Nuhsb. 



the physician must harmonize, because 
they are identical. 

In order to treat this problem honestly 
and eliminate ray own personal bias in 
so far as possible, I have invited the co- 
operation of some fifty or more physi- 
cians, selected somewhat at random, and 
representing all sections of the United 
States. In order to bring out most di- 
rectly the facts and opinions germane to 
the problem, the following questions 
were propounded : 

1. Do you know of many people who 
are, financially or otherwise, unable to 
secure the services of trained nurses in 
the event of illness, and who cannot be 
considered as objects of charity? 

2. Do you think that trained nurses 
as a profession are performing their duty 
to this class of patients? If not, why not? 

3. In your experience what care — 
medical and nursing — do these sick ordi- 
narily receive, and at about what ex- 
pense ? 

4. Would it be feasible for your hos- 
pitals to care for all these cases at an 
equal expense per patient? Please ex- 
plain your answer. 

5. In your opinion what is the most 

Nurses. Syrnciise, October, 10(17. and Contributed \o 



THE TRAINED NURSE AND HOSPITAL REVIEW 



feasible plan for improving the status 
of this class of patients, so far as nurs- 
ing is concerned? 

6. Do you wish that I should regard 
your answers as confidential, or are you 
willing that I should quote you? 

Over forty physicians took sufficient 
interest in these questions to send me 
their replies. These have been carefully 
collated and will form the basis of this 
paper, which I would like to have you 
consider a symposium rather than an ex- 
pression of my personal views. As I 
have received permission, I shall not 
hesitate to quote freely from these let- 
ters wlienever it seems appropriate, 
rather than use words of my own. 

In reply to question i, three-quarters 
of the answers give positive evidence of 
the existence of a large class of people, 
not usually ranked as dependents, who 
are unable to secure the services of the 
trained nurse in time of need. One physi- 
cian says that four-fifths of his patients 
belong to this class; four others place 
the proportion as high as ninety per cent. 
A woman physician in a large city writes : 
'T am in that very class myself." 

Only two doctors, a country practi- 
tioner in Nebraska and another country 
practitioner in Western New York, 
answer this question with a decided No." 
They both add, however, that the dis- 
tance of the farmer fro-n large cities, not 
his poverty, makes the employment of 
trained nurses almost impossible except 
in cases of "dire necessity." 

It is, therefore, totally unnecessary to 
assume that a considerable proportion of 
the sick are, under present conditions, 
out of reach of the trained nurse. We 
know that this class exists in almost 
every community. It may be in order, 
however, to inquire 7vho they are and 
how we may know them. As the stand- 



ards of living are not the same in all 
communities, so, of course, the signifi- 
cance of the phrase "moderate means" 
changes in passing from place to place. 
A Chicago physician, in explaining this 
term, says: "I mean men employed in 
commercial establishments, tradesmen, 
small store keepers, even a certain per- 
centage of professional men, etc." A 
woman practicing in a large industrial 
city says: "All persons who are sup- 
porting a family on $8 to $15 per week 
would come in this class." We note 
also that it is not always the lack of 
money that prevents these people from 
employing trained nurses. It may be 
that the family lives in one room, or that 
for some other reason it seems impossible 
to house the nurse, though we must 
hasten to admit that frequently the 
friends of the patient exercise wonderful 
originality and fertility of resource in 
contriving places for the nurse to sleep, 
if, indeed, it be thought necessary that 
she should sleep at all. 

Before considering the second ques- 
tion, the obvious duty of the nurse to 
these unfortimate people, it will be best 
to proceed to the discussion of quest'ons 
3 and 4. 

The replies to question 3 generally 
state that, so far as medical attention is 
concerned, these patients receive as good 
treatment as those of any other class. In 
many cases the physician collects his 
regular fee ; in most cases he discounts 
his fee twenty-five to fifty per cent, and 
sometimes he gives his services without 
charge. 

The nursing of these cases, on the 
other hand, is usually performed at little 
or no expense to the patient, by friends 
and relatives — "anxious and overworked 
members of their families," as one doc- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



tor puts it — or, according to another, 
"some old woman that can be had for 
her board or very small compensation, 
the older woman commanding the greater 
confidence providing she isn't blind or 
lame enough to need a cane." In this 
connection one of our city correspondents 
reminds us that nursing by friends and 
neighbors "has gone out of fashion, mak- 
ing the care of the sick a problem for 
the trained nurse, physician and family 
to solve." Doctors are generally dis- 
posed to condemn the kind of home care 
just alluded to, although often obliged 
to put up with it and even to assist in it 
by teaching and admonishing the amateur 
as occasion seems to demand. Several 
doctors speak appreciatively of the eager- 
ness and .cleverness with which such 
ex tempore nurses — especially young 
mothers — receive every bit of instruc- 
tion, but as a general thing they judge the 
amateur nurse by our modern high stand- 
ards of nursing, and pronounce her in- 
competent. 

If an effort is made to secure a paid 
nurse for the patient of moderate means, 
it usually results in hiring an untrained 
woman with more or less practical ex- 
perience, as the phrase is, or some one 
who has taken a part of the regular 
training school course, or one of the 
products of the correspondence school 
or other institution which prepares 
women by some sort of short cut for this 
field of activity. The expense of this 
untrained or partially trained nurse will 
vary from $5 to $18 per week, her aver- 
age wage being about $12, according to 
n:y information. As a rule, this kind of 
nursing is regarded by the physician as 
unsatisfactory — a verdict not quite so 
severe as that which he would pronounce 
against the friend or neighbor who as- 
sumes the role of nurse in lieu of a better 



attendant. Several of my correspond- 
ents, however, testify that these nurses 
are very good ; one physician — a woman, 
too — says that her $12 practical nurses 
do better work under her personal direc- 
tion than the trained nurses with whom 
she has been associated; while sev- 
eral other physicians affirm that 
these nurses are worse than none 
at all. From all the evidence we are 
certainly justified in concluding that 
the really competent practical nurse 
is usually in such great demand that she 
asks and receives almost the same, if not 
just the same, wage as the trained nurse 
herself, and for that reason she, too, is 
out of the question in families of moder- 
ate means. 

A few of the cases under consideration 
are fortunate enough to go to the hospi- 
tals for $8 to $12 per week. Others em- 
ploy well trained hourly nurses at fifty 
cents to $1 per hour and thus receive ex- 
cellent service. A few accept the offices 
of trained nurses supplied to them by 
churches, societies, lodges, etc., and thus 
become, for the time, recipients of char- 
ity. In a few rare instances the trained 
nurse donates her services. 

The majority of our correspondents 
would undoubtedly subscribe to the opin- 
ion of Dr. A. T. Bristow, of Brooklyn, 
that "there is no economy in employing 
nurses other than the regular trained 
nurse." It follows, then, that the class 
of patients under consideration are pay- 
ing very dear for a very inferior service 
in the line of nusing. 

Let us see now, in considering question 
4, whether we can reasonably ask the 
hospitals to care for all these sick people 
without increasing their burden of ex- 
pense. About 15 per cent of the physi- 
cians answer this question in the affirma- 
tive. Several believe that all surgical 



THE TRAINED NURSE AND HOSPITAL REVIEW 



cases can easily be accommodated in 
their hospitals. One physician in Buffalo 
is sure that every acute case can find 
room and good care in the hospitals of 
Buffalo at no greater expense than would 
be involved in their homes, and he shows 
his faith by his daily practice. Two men 
located in small cities, in New York 
State and North Carolina respectively, 
believe that all cases in this class can 
now be accommodated in their hospitals 
at less expense than at home. On the 
other hand, fully three-fourths of the 
physicians replying are positive that all 
the patients of this class cannot be ac- 
commodated in their local hospitals. The 
reason commonly given is that there is 
not enough room at any price for all 
these people, and several answers imply 
very distinctly that there is no disposition 
on the part of their hospital authorities 
to increase their capacity for the accom- 
modation of such a cheap class of cases, 
viz. : those paying $7 to $12 per week. 
Various causes are cited in support of 
the opinion that hospital care costs the 
patient more than home care. Again, in 
the rural districts it is simply impossible 
to expect hospitals to assume this work. 
In city and country alike, we will find 
the hospitals caring principally for the 
well-to-do and for the extremely poor. 
The man of moderate means finds the 
conditions existing there considerably 
below his inclinations, or else so high as 
to be out of reach. In short, we are 
led to conclude, in the words of Dr. 
James Tyson, of Philadelphia, that "it 
is not in the province of a hospital" to 
care for this class. 

As might be expected, it is the chronic 
cases and the convalescents who suffer 
most from this lack of hospital conveni- 
ences. But we must add to these the 
ignorant and the prejudiced — those peo- 



ple whose superstitions and narrowness 
keep them from many of the comforts 
of civilized life — hospitals and trained 
nurses included. The reflections of Dr. 
Clements, of Buffalo, on this class of 
patients sound almost like a caricature, 
but those of us who know are able to 
take them very seriously. He observes 
that many of these cases keep far away 
from the hospitals. 

"For the reason that all would have 
to be classed alike, and some think they 
are better than their neighbors — came 
from better stock, or husband holds a 
better position — are better educated, etc.. 
etc. Some would look upon a hospital 
as a butcher shop, others had rather go 
to jail, many would prefer to die first. 
Some would not go where they could not 
have their family physician, no matter 
how much more knowledge or experience 
the interne might have had." 

Dr. Bristow, of Brooklyn, brings the 
same facts right home to us : 

"There are reasons of prejudice, of 
taste and family reasons why these peo- 
ple either will not or cannot go to the 
wards of the hospital. How many doc- 
tors with modest incomes cross the At- 
lantic on a first-class passage, emulating 
the millionaire when they really cannot 
afford it! They ought, from their finan- 
cial status, to take a second cabin pas- 
sage. When they reach the other side 
thev will travel third or second in the 
railways. Yet you and I would not take 
a second cabin passage across the Atlan- 
tic. The same reasons apply to the pa- 
tient of modest means who is asked to 
give up his home and go to the hospital 
ward. You cannot change human na- 
ture." 

To sum up this matter, the majority 
of patients of moderate means cannot be 
treated in the hospitals under present 
conditions, and many of them would 
never go to the hospitals even if they 
could. The problem of their care i.^, 
therefore, the problem of home care. 




THE TRAINED NURSE AND HOSPITAL REVIEW 



We come now to the physician's idea 
of the responsibiHty of the trained nurse 
toward the patient of moderate means, 
and I will try to present a composite of 
the many varying answers to question 2. 
Considerably more than half of the re- 
plies say no to this question; but a close 
analysis of the arguments advanced in 
support of this answer shows that in most 
instances the author's no means yes. The 
gist of these negative answers is this : 
The trained nurse does not do her duty 
to these patients simply because she 
cannot afford to work at their price, 
while, on the other hand, she usually 
ges enough to do at her maximum rate. 

It is an axiom in economics that the 
wealthy class has its rights as well as the 
poor class. Under the existing condi- 
tions of demand and supply the trained 
nurse finds herself, certainly through no 
fault of her own, so fully employed in 
the service of the well-to-do that she 
has little occasion, in many instances, to 
accept employment in the family of lim- 
ited means. So far as this is true the 
nurse is fortunate. While several of our 
correspondents deprecate the commercial 
spirit which they fear is dominating the 
nurses as a profession, no one is so un- 
reasonable as to suggest that their prices 
are exorbitant, even though they are pro- 
hibitive to a large element of society. 
The following statement by Dr. J. White- 
field Smith, of Bloomington, 111., aptly 
expresses the sentiments of many of the 
writers on this point: 

"When we come to consider the ex- 
pense of living in our large cities, we 
must conclude that her remuneration is 
very meager, and for this reason the 
nurse cannot afford to do her work for 
l('^s rnmjicnsalion than she is getting. 

(7^0 be continued.) 



Her salary classes her in the same cate- 
gory as those of moderate means, and 
she is in no better position to offer her 
"services as a charity than the classes of 
people known as those of moderate means 
are enabled to oflfer their earning capac- 
ity in any direction for less than they 
can command, or for half pay, or as a 
gratuity. Hence it must follow that 
because of such limitations, and in order 
for the nurse to rightly discharge the 
duty that she owes herself, she cannot 
afford to make a sacrifice to reach the 
middle classes." 

Dr. Maude McConnell, of Indian- 
apolis, writes : 

"In my experience I have known but 
two nurses who did not have to earn their 
living. Physicians criticise nurses very 
severely for their lack of appreciation of 
the people of moderate means, whether 
justly or unjustly I am not prepared to 
say; but I often wonder if they stop to 
realize that a nurse cannot give a few 
minutes or an hour or two in a day, but, 
when she gives, must give all her time." 

We might fill several pages with simi- 
lar expressions showing that the physi- 
cian does not demand or expect that the 
trained nurse shall give her time and her 
living for charity. Others testify that 
she does give. Dr. William H. Hodge, of 
Niagara Falls, says: "I have always 
found the nurses willing to care for this 
class of cases at a reduced rate." A 
country doctor in New York State says : 
"The average trained nurse makes greater 
sacrifices in every way than the average 
physician." In view of all these cordial 
expressions, and of many similar senti- 
ments which we have not time to quote, 
let us credit the physician with a fairly 
good insight into the economic aspects 
of this problem, and a due appreciation 
of the present attitude of the trained 
nurse toward the general public. 



9inoti)tr '^it\xi of hospital Woxh among tlje $oor 



BY A R. N. 



THE paper read by Jane Addams, of 
Hull House, at the convention of 
The American Hospital Association, in- 
clines me to refute, balance or explain, 
instance for instance of these, the lay- 
man's impressions. After an experience 
of as many years in hospital life as Miss 
Addams has had at Hull House, .an ex- 
perience from the different viewpoints 
of nurse in training, ward head nurse, 
night superintendent, superintendent of 
training school and superintendent of 
hospital, I feel justified in saying that, 
first, last and always, the patients' wel- 
fare is the hospital's chief concern; not 
only should it be, but it is. 

I believe if all the patients who have 
passed under my observation, rich or 
poor, helped, cured or lost, could have 
left individual answers to the question, 
"Has the hospital done justly by you?" 
eighty per cent would have answered 
"yes." Of the other twenty per cent, 
eighteen would have been those who, 
from their own natures would not have 
been satisfied with any conditions, and 
the remaining two per cent — and I think 
it a very large estimate — the regrettable 
mistakes which will always occur while 
human organization and management re- 
mains the fallible quantity it is. 

The Trained Nurse spoke editorially 
some time ago in reference to the com- 
mon complaint that the comfort bf the 
individual patient is sacrificed to the ap- 
pearance of the ward, saying that the 
doctrine of the greatest good to the great- 
est number explained many seeming in- 
consistencies and giving, if memory 
serves me correctly, this order of consid- 



eration : First, the welfare of the whole 
body of patients; second, the welfare of 
the individual patient ; third, the comfort 
of the whole body of patients, and 
fourth, the comfort of the individual pa- 
tient. A moment's reflection shows this 
to be sound reasoning, ethically and pro- 
fessionally correct, although the patient's 
comfort, which often means his satisfac- 
tion in some trivial matter, is placed as 
fourth in order of consideration. VVc 
cannot expect every patient, nor every 
patietit's friends, to appreciate all this, 
but we must pursue it as being the fair 
course, nevertheless. 

I think the instance cited of the patient 
annoyed by the nurse folding sheets in- 
stead of waiting on her is well balanced 
by a happening in my own ward. Mr. 
Brown, convalescent from a fractured 
leg, was petulant, whining and always 
wanting something done for him. It was 
four o'clock, visitors just gone, leaving 
the ward in the distracting confusion of 
chairs out of place, spreads awry, tables 
littered with debris — every nurse knows. 
Miss A. and Miss B. came back from off 
duty, one to the dressings, the other to 
take temperatures, give medicines and 
put the ward in order; suppers came at 
quarter of five. Mr. Brown asked for a 
trifling thing, f think it was to get a 
packages of magazines left for him at 
the office. Miss B. said she would go 
as soon as she had time, but that she 
must put the ward straight first. "I sup- 
pose," said he, "if I were dying, yon 
would put the ward straight." "I cer- 
tainly would, Mr. Brown," was her only 
reply, and she did put it straight. I took 



THE TRAINED NURSE AND HOSPITAL REVIEW 



no notice, but I overheard. some excited 
talking in Mr. Brown's vicinity. "She 
said she wouldn't do a thing for me if I 
was dying, and I'll report her," was one 
remark. When her work was done she 
went back and said quietly, but so others 
in the vicinity could hear : "For you or 
for any other patient, if dying, or if 
needing my care for serious or trifling 
matter I should do all that was requisite, 
but I could and should keep my ward 
straight also. Your jealousy of any act 
not directly contributing to your personal 
desire is a shame to the ward," It is not 
the province of the ward nurse to correct 
or discipline the patient, but it was a 
needed lesson well given. Not only Mr, 
Brown, but the whole ward benefitted 
by it. 

I believe the complaints of the kind 
cited would, if thoroughly understood, be 
accounted for in large measure by the 
patient's jealousy of any act not directly 
contributory to his personal desires. 
Should we use no discrimination in what 
must be given precedence we would 
cause real suffering where now it is only 
the inconvenience of waiting one's turn 
in accordance with the real need. 

The instance of the nurse telling the 
patient to keep still until the doctor came 
is laughable only. We do not criticize 
the mother who, when her children are 
all "cleaned up," admonishes them to be 
careful and not get all mussed up before' 
company comes. We do not think her 
mireasonable, or that the children cannot 
enjoy themselves. The nurse is not 
severe or cruel when she tells her pa- 
tients to keep their beds straight. A 
large proportion of patients who are 
well enough to take interest in things will 
be pleased to do it. The patient is more 
comfortable in a neat, straight bed than 



with it tumbled, and if he is able he 
should help to keep it so. 

The actual discipline of a ward of 
twenty-four patients is no small matter, 
and discipline in the ward is equally 
or even more necessary than when any 
equal number of people are handled as a 
whole. If individual proclivities were 
not restricted and uniform conduct in- 
sisted upon, pandemonium would ensue. 
The irate woman who insisted that I 
must not interfere if her husband want- 
ed to lie with his head at the foot of 
the bed and one foot out on the floor 
would scarcely have wanted the patient 
in an adjoining bed allowed to "whistle 
because he felt like it," as he did feel 
like doing at 3 A. M. Her argument 
that it was "bad for sick people not to 
have their own way," was equally appli- 
cable to this case, however. To the senti- 
mentalist the very word or suggestion of 
discipline in connection with these "poor 
sufferers" calls forth a tirade of indigna- 
tion at our hardheartedness. 

Perhaps a patient in one bed may not 
appreciate being patted and called "dear" 
while one in the next bed is one who is 
sorely troubled at the impersonal atti- 
tude of the nurse; which same imper- 
sonal treatment Miss Addams criticizes 
in another paragraph. 

In a ward of twenty four patients, 
constantly changing, the nurse must be a 
very versatile woman who adapts her- 
self unerringly to the method of ap- 
proach most pleasing to each individual. 
Nurses are taught that they should be 
"all things to all men." I trust I may hr 
pardoned the flippancy of adding the im- 
possibility of being all things to all 
women. Another instance : 

One morning the colored woman in 
bed 14 said to me : "I jest does love that 



8 



THE TRAINED NURSE AND HOSPITAL REVIEW 



little black haired nuss to fix me up. 
When I'm all done she gives me a little 
poke and says, 'Bress your gizzard.' " On 
the other side, in bed lo, was a maiden 
school teacher of some years, or more, 
and she told me that she thought Miss 
G. far too undignified for a nurse. She 
actually almost plays with that negro." 
I thought it would be more congenial all 
around if I sent Miss H., also of some 
years and once a teacher, to care for the 
teacher patient. They quarreled over 
how the bed should be made until I was 
obliged to report the nurse for unbecom- 
ing conduct and the patient for refusing 
to comply with hospital regulations. 

As a general rule, the less sick a pa- 
tient is the harder it is to satisfy him. 
Human nature is about the same article, 
and hospital patients possess their share 
in indirect proportion to the seriousness 
of their ailment. Why? I do not know. 
The sentiment that attaches itself to 
nursing, that establishes the standard of 
every want anticipated by the nurse, who 
is a beneficent, hardworking, omniscient 
angel, existing for the patient's comfort 
and happiness, receives a rude jolt from 
the practical sometimes. There were sev- 
eral critical cases in the ward, cases 
where immediate and continued attention 
was necessary to save life, but the pretty 
patient in bed 3, whose arm was in a 
sling from a hurt elbow, cried and com- 
plained bitterly because the nurse Would 
not do up her hair in curlers in anticipi- 
tion of the visiting hour. When she goe«? 
home and tells the story the layman will 
be very apt to sympathize and say : "Why 
couldn't the nurse do it for you? It 
wouldn't take but a minute. That's not 
the way to treat patients." 

Our city has a home for fallen women 
and our maternity ward cares for the 
cases from there. Once with us they are 



distinguished in no way from the other 
patients. Instance comes to mind of a 
young girl brought to us, the head of the 
home coming at the same time, to explain 
what she called the "wanton obstinacy" 
of the girl, who refused to give her own 
or her parents' name or address. This 
woman deemed it incumbent on her to 
give final admonition and reproof to the 
girl in this wise : "They will be good to 
you here, Jennie, not because you de- 
serve it, but because we sent you here. 
You must keep your child ever witii you. 
Your punishment before the world," anc' 
more and more of the same sort before 
she left and, did it not sound undignified 
with reference to so important a person- 
age, I should say that the nurses hustle 1 
her out. Miss K., who took the patient 
in charge, saw she was in a nervous con- 
dition manifestly unfitting her for the 
physical ordeal she must undergo, an«! 
cheered and sympathized with her. Jetmie 
has told me since that when Miss K. gave 
her hand a squeeze and her shoulder a 
little pat and whispered, "Don't you care, 
it won't happen again" ; unconsciously 
using the phrase that an older brother 
had used to comfort the hurts of child- 
hood, she received her first bit of incen- 
tive to go on with her life and make her- 
self a good woman. And she had been 
for two months in this "shelter," this 
"home!" We found a home for the baby. 
It will never know its parentage, it is 
true; but neither will Jennie's father, 
mother or brother know of that which 
would cause them intense grief and 
shame. Jennie's sin is not before the 
world. She 7nay make a good woman ; 
we thought she was worth the chance. 
Would the home have helped her more 
than the criticized "impersonal treat- 
ment" of the hospital? 
"The long-delayed operation" couldn't 



THE TRAINED NURSE AND HOSPITAL REVIEW 



have happened in any of the hospitals I 
have chanced to be connected with. 
There was a faidty system to account for 
it; but granting it as true and a most 
unfortunate occurrence, and the hospital 
utterly at fault, has the hospital ever re- 
"ceived credit for the .hundreds of times 
it has acted promptly and efficiently in 
just such cases? That is its duty, I 
know, but is there ever any s;^stem what- 
ever its intent or completeness but that 
"falls down" sometimes? 

Hospitals are criticized most sarcastic- 
ally for sending out patients too soon. 
Convalescents are not sufficiently consid- 
ered. Would the criticism be less severe; 
the hospital considered less culpable, if it 
was found without room for the patient 
brought to its door? A small hospital 
with which I was for a time associated 
was accused of keeping its patients too 
long for, it was said, if the hospital were 
full a new case must be cared for at 
home and the doctor get a fee ; that was 
the argument. I give it for what they 
thought it was worth. It all depends on 
the point of view. 

Hospitals seem to be able to please 
some people all the time; most people 
much of the time, but charity cases — 
never. I will qualify that and say almost 
never. For the truly worthy and appre- 
ciative recipients of charity are not an 
inconsiderable number, though they arc 
an almost inconsiderable percentage. I 
kept a complaint book for one year, re- 
cording every complaint made to me as 
superintendent and many others made or 
reported non-officially. Twenty per cent 
of the complaints were exactly offset by 
another twenty per cent whose com- 
|)laints were of exactly the thing asked 
for as a remedy in the other cases. Fifty- 
eight per cent of the complaints were 



made by charity cases, and this in a hos- 
pital where the patients were the usual 
proportion of pay and charity cases 
which a medium sized city furnishes. All 
were treated alike, neither nurse nor 
house doctor knowing whether cases 
were on a pay or a charity basis. 

Once when I was speaking to my 
nurses on the avoidance of slangly inele- 
gant hospital parlance, I had occasion to 
reprove the use of the term "C. C." 
which was being used to indicate a re- 
fractory or disagreeable patient, and 
variously interpreted as "cranky case," 
"contrary customer," etc. To me it read 
charity case, so plainly ; and so synony- 
mous was that reading in my mind with 
the current interpretation of the letters 
that I actually feared my ability to make 
the lesson a forcible one. I do not feel 
that my spirit or the spirit of my hospital 
is "a little less human, a little less courte- 
ous to the recipient of charity." I am 
not hard on the recipient of charity as 
such, but I am hard on those most de- 
spicable of human characteristics, false 
pride, jealousy, selfishness and thankless- 
ness that walk hand in hand with the 
charity case. I have been taught and 
been teaching for many years that the 
duty, the province, of the nursing profes- 
sion is to alleviate suffering, regardless 
of character or condition of the per- 
son who at that time represents the rea- 
son for the profession's existence. The 
patient's need, not his worthiness, is our 
concern, and I believe that hospitals and 
our profession of nursing as a whole live 
up to that ideal in spirit and in letter. 

The education and importance of the 
interne and of the pupil nurse come in 
for their share of sarcastic comment. Of 
the interne, if any other system can be 
instituted whereby equally efficient or 



10 



THE TRAINED NURSE AND HOSPITAL REVIEW 



better service can be furnished on a prac- 
ticable economic basis, hospitals would no 
doubt be ready to accept it. There are 
internes and internes, differing just as 
the same number of men in any other 
position will differ. To the hospital he is 
one factor to be amalgamated into the 
whole composition; not the person of 
authority and importance that he seems 
to our patients or our critic. 

The pupil nurse and her relation to 
the situation is a subject on which the 
leading minds of the nursing profession 
are thinking deeply, and on which I 



will not venture to express one thought. 
I remember a little iiand-wrought card- 
board motto, a treasure of childhood. 
The cross stitches of wool formed the 
admonition, "Be not weary in well do- 
ing." After twenty years of working I 
wonder if I have lost power to live up to 
my motto when I feel weary, literally 
tired at the lack of comprehension of 
what we do. Or is it that all the time I 
have not been "well doing" and need the 
"layman's view" to aid me. Perhaps, but 
we will jog along according to our own 
conception of things a little while longer. 




THE DOCTOR, BATTLE HARBOUR HOSPITAL. 



Battle Harbour Hospital in tfje jFro?en JBtort!) 



FELIX J. KOCH. 



/^ F course we had heard much of it — 
^-^ the famous hospital established 
away up among the icebergs on the 
coast of Labrador, for the twenty thou- 
sand odd fishermen inhabiting that coast 
in the Summer, and how, out from it and 
its sister hospital at Indian Harbour, Dr. 
Grenfell made his flying trips up coast 
and down to visit the sick and bring the 
very ill on his vessel to these shelters. 

It was therefore not without a feeling 
of badly suppressed interest that we 
neared Battle Harbour. 

There was only the one boat to take, 
and it a sealer, plying from St, John's, 
so just the respite from her decks proved 
welcome. Ten minutes past ten we 
were approaching Battle Harbour. It 
was a long, rough, rock-lined coast which 
unfolded. Mountainous hills for back- 
ground and on these what seemed glacial 
scratches. At one or two points one saw 
a house, the "town," as it seemed, was in 
a nook of the hills, otherwise only the 
palisaded mountains rose from the waves 
that broke on the shore. At their feet 
was the ice choking the beach, though we 
were in mid-August. 

Wc could sec the harbor trending far- 
ther along on the left; on our right the 
ocean was filled with bits of floating ice. 
In this glace one or two skigs lay at 
anchor. 

Bays opened off with great floating 
masses of ice. Beside the shore there 
was rock alone, and in it queer stripings 
of pink granite. 

We could see bergs everywhere. One 
huge iceberg had assumed a cone shape. 
Next another circled about, these of a 



magnificent blue-green, with a few ridges 
upon them and, again, serrated as was the 
palace of the ice king in one of Ander- 
sen's Fables. 

Behind again were the grim rocks, 
with a few islands and an iceberg of a 
pretty, clear-cut form, much like a huge 
block of ice of purest white. Over on 
the right rose another, in fog, with the 
sun melting this at its top and causing all 
manner of vapor. To right and left arc 
these, one square the other pointed. Then 
still again, we see low ridges of ice like a 
reef. A ship lay here bound for Hud- 
son's Bay. 

As to the Harbour itself, it was 
blocked by rock islands, and on these 
there stood what seemed wigwams of 
poles, really the trestling for the fish- 
flakes. A bit of a cottage and a frame 
house; then behind, the settlement of 
Battle Harbour and the Mission Hos- 
pital, a neat two-story frame standing 
well above the shore. 

It was twenty minutes to eleven when 
we cast anchor. The mail and the men 
went ashore in the dory. 

We would row by an island with a 
little teepee of poles and bearing a small 
shack, with moss on its roof, to the main- 
land of Labrador. It was our first land- 
ing on that coast. 

All in all, it seemed there might be 
twenty houses, of white with black roofs 
sloping from the centre down to front 
and rear. A door between two mani- 
partite windows. There was a church 
with red decoration, and a school with 
three, quccrly pointed windows. 

Farther alonj;-, inside the liarljor, there , 



12 



THE TRAINED NURSE AND HOSPITAL REVIEW 



were no houses at all, thanks to the rocks, 
but here innumerable schooners had an- 
chored. 

All of the settlement therefore lay on 
the left as we rounded in against the 
steep rocks ; and here, too, was the goal, 
the two buildings of the Deep Sea Mis- 
sion. 

Bungalows in style were these and on 
the outer wall, across the two, there ran 
the familiar: "In-as-much as Ye Have 
Dniic It Unto the Least of These." 



and cord, and cases of endless content. 

Then we were led back to the hospital 
and taken in, to a central hallway at 
right and left of which reception rooms 
opened off. 

At one side was the "sisters' reception 
room," and here an organ and a table. An 
American flag was among the pictures 
on the wall. On the floor, skins of the 
fox caught the eye. 

On down the central hallway we came 
to the dispensary. Then to the waiting 




A LAND OF BERGS. 



On the veranda an Eskimo boy, in 
hood of white — this edged with fur, 
where the cape fell on the back — and 
coat as white to match, sat on the rail. 

Through the door of this hospital one 
saw inside great rows of plants, mari- 
gold, geranium and begonia, while from it 
we could overlook the great fish-flake to 
the town. 

It was cold, though the mercury stood 
at sixty degrees, and one was glad to step 
inside. 

First, however, we must visit the store 
that served for post office. The shop 
was very dark, indeed. Half-way down 
the centre a great counter of some dark 
wood extended, and on this there were 
^ boxes of fish hooks and canned foods 



room, with benches to right and left. Out 
by a rear door we passed into the other 
building of the hospital — the hospital 
proper, it might be called. 

In the "ladies' room," as it is known, 
are white iron cots; on the walls there 
are cards bearing Biblical inscriptions. 

Two women are patients here, and a 
nurse in black, with apron of white, at- 
tends them. 

The doctor shows us a little girl, bitten 
by the savage Eskimo dogs. There arc 
many cases such as this, and so Dr. Gren- 
fell, of Deep Sea Mission fame, is advo- 
cating the abolition of the dog in favor 
of the reindeer. 

In this case the dog had almost torn 
the leg off the child. It is a strange fact, 



THE TRAINED NURSE AND HOSPITAL REVIEW 



13 




CATTLE HARBOUR. 




TIIK UOSl'lTAL. 



14 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the doctor says, that these dogs produce 
no hydrophobia, and that they do not bite 
in the same way as does the regular 
canine, being really more wolf than dog. 

The doctor here is a young Scotchman, 
and his white flannel jersey and cap and 
his Scottish accent strike one curiously 
in the far Labrador. 

He is telling of the one or two cases 
they have from the dogs each year as he 
leads the way up the rubber-topped 
stairs, and we pass a graphophone on the 
landing to the second floor. 

A very modern operating room is lo- 
cated here, all of the walls done in what 
seems white linoleum. At the centre a 
very up-to-date operating table is placed. 
In a corner there is a white enamelle I 
bottle rack. 

We go into the men's rooms. The 
cots here have the red and white striped 
blankets, and the walls are of wood. On 



them are inscriptions from Scripture on 
placards. 

Back again in the parlor we see over 
the mantel some young seals and some 
mounted gulls; rugs of skin are on the 
carpet. 

They requested our autographs — they 
have those of Root and Peary; it is al- 
most steamer departure time, and we 
must return to the wharf. 

We bring the kodak into play. Out on 
the edge of the harbor, with the sun on 
the water, the line of rocks about, the 
great fish flake and the ice close in shore, 
one gets some striking pictures. It is 
warm and balmy now, almost hot, as 
one climbs the heights behind the town 
to the IMarconi tower there. 

We saunter about, half aimlessly, and 
again snap-shot the young Eskimo. Then, 
five minutes past noon, in the lovely sun- 
lijjht on the water, again we go aboard 



Care of ;jHatteli l^air 



DO not worry if your patient's hair 
is becoming badly tangled and 
matted and she is not able to have it 
combed. 

Use white vaseline freely each day un- 
til the hair is thoroughly saturated, then 
when your patient is able commence at 
the ends of the hair, using the fingers 
more than the comb, and work gradually 
towards the scalp. Never use the comb 
next to the scalp until the tangle has 



been straightened. You will be aston- 
ished what wonder can be accomplished 
with an apparently hopeless tangle of 
hair. 

I have never yet seen hair I could not 
untangle without scissors or discomfort 
to the patient, and I have met some 
knotty problems in my twelve years' 
practice among fever and nervous pa- 
tients. 

B. E. M. 



Cije Walue of ^arliametttarp ilato on tije jf loot 



CORA WELLES TROW. 



^ I ''HE desire to have her own way is 
-■■ inherent in the breast of every 
woman. It may be the right way, or it 
may be the wrong way; whether it be 
right or wrong is not the point at issue, 
it is her way and she wants it. We are 
sorry to admit it, but the average woman 
who attends the average meeting is not, 
as a general rule, influenced as much by 
logic in forming her opinions as she is by 
sentiment. "I know," said a woman re- 
cently, "that the chairman of that com- 
mittee has not done an earthly thing, but 
I am going to move that we give her a 
vote of thanks for her efficient work, 
because it is a nice, graceful thing to do, 
and you know she is a dear, even if she 
is inefficient." 

The woman who attends the meetings 
of any organization generally does so 
from mixed motives, she wants to know 
what is going on and she wants to be 
amused. As a rule she takes very little 
interest in the business part of the 
proceedings, and only feels bored 
when asked to consider some de- 
tail in which she is not interested. 
Some day she wakes up to the fact that 
there is something she would like her or- 
ganization to do, some course of action 
sjje would like it to pursue. The thing 
seems so attractive to her that she never 
doubts it will be carried. She proposes it 
and her suggestion having been seconded 
and then as a motion repeated by the 
chair, the opportunity for discussion is 
given. The president calls attention to 
the fact that the mover of the motion is 
the one who should first speak to it. Our 
friend rises in a very embarrassed condi- 



tion. She explains that she had not in- 
tended to speak, is not prepared to speak, 
does not know really what to say, and 
after consuming a good deal of valuable 
time, sits down without saying any- 
thing. 

An opponent of the motion rises and 
in a few well chosen words speaks 
against it ; the motion is lost and the lady 
proposing it goes home alive, for the 
first time, to the fact that it is essential 
to have a reason as well as an idea. The 
President of the United States remarked 
many years ago that the man who under- 
stood parliamentary law was the man 
who controlled the meeting, and it is 
just as true to-day. 

The proceedings of a meeting are un- 
('er the direction of the presiding officer, 
the action taken at the meeting is under 
the direction of the people composing the 
meeting; that is to say, a majority vote 
decides. To be al)le to speak in such a 
manner as to influence the vote, is the 
first requisite necessary for the obtaining 
of your own way ; therefore it is one that 
should be cultivated by all women. 

When any motion comes before the 
meeting it is calle<l the question before 
the house, and remains there until 
answered. The answer may be deferred, 
but sooner or later the question is 
answered. All such answers are obtained 
by taking a vote. The simplest metho 1 
is to ask for the ayes and noes. The pre- 
siding officer says : "All in favor will 
say aye; opposed, no." Then she an- 
nounces the result of the vote by saying, 
carried or lost, as the case may be, and 
all motions except those that are with- 



16 



THE TRAINED NURSE AND HOSPITAL REVIEW 



drawn are entered in the minutes with 
the result of the vote taken. 

It frequently happens that a motion is 
introduced that is unpleasing to many 
present, and yet seems liable to be carried 
because of a general disinclination to 
oppose it. In this case it is wise to move 
to lay the motion on the table. This 
motion admits of no discussion, and is 
often a welcome escape from a trying 
situation. The motion may be taken off 
the table at any time and further dis- 
cussed. If, however, you feel that the 
motion is not being intelligently discuss- 
ed, it is wiser to move a postponement of 
the question and when the time arrives to 
which it is postponed, be prepared to 
speak to it in such a manner as will 
bring about the result you desire. 

Parliamentary law is nothing if not 
polite, and every breach of good manners 
is also a breach of parliamentary law. As 
children we were admonished not to 
speak unless spoken to, and as children 
of a larger growth, the admonishment 
still holds when we are attending 
meetings. No matter how tired you may 
be of a discussion don't call "question" ; 
it only proves you a badly behaved per- 
son. If you want discussion to close you 
can call for "the previous question," and 
if that obtains a two-thirds vote, the 
question before the house is immediately 
put to vote. 

A good presiding officer will be able to 
determine the time to close discussion, 
and she may then say, "Are you ready 
for the question ?" It is now in order for 
you to say "question," you having been 
spoken to. If, however, there is one ob- 
jecting voice, the presiding officer must 
take the vote of the house as to whether 
discussion shall close or continue. 

Politeness further teaches us that we 



should always rise when we address the 
presiding officer, and never address the 
house until she has introduced us by re- 
peating our name. Having thus ob- 
tained the floor, we can introduce the 
matter we have in mind. There are a 
great many "don'ts" to be remembered. 
Don't begin by saying why you are going 
to make the motion you intend to intro- 
duce. Say "I move" thus and so, and 
then when the question is open to dis- 
cussion, tell why you have brought the 
matter up. Don't say, "It seems to me." 
Every one knows as soon as you rise how 
it seems to you, as you have to speak 
either for or against the motion. The 
question is not how it seems to you, but 
how you want it to seem to your hearers. 
Don't speak in such a low voice as to 
make it impossible for all to hear. Don't 
speak too long. Don't get up to speak 
on one subject and speak on another. 

If you do the last of these you are 
liable to be called to order. A member 
can then rise to a question of order and 
ask the Chair if your remarks are rele- 
vant, or the Chair can call you to order. 
Remember that the time consumed by 
the meetings belongs to the members 
present, and must be devoted by them 
to the legitimate lousiness' they have 
come together to transact, and anything 
irrelevant to the business before the 
house is out of order. 

When a motion is being discussed that 
you like but feel to be inadequate, amend 
it. This you can do by suggesting a 
change in the wording, but four amend- 
ment must be germane to the matter be- 
fore the house. When the first Continen- 
tal Congress was in session a motion was 
introduced to the effect that a sum of 
money should be appropriated to pay the 
soldiers serving in the army. An amend- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



17 



ment was suggested that the money 
should be appropriated for harbor de- 
fense. This caused a heated discus- 
sion and resulted in the passing of a law 
that all amendments must be germane to 
the sense of the main motion or, in other 
words, the question to be amended. You 
may amend a motion and then amend the 
amendment, and when the vote is taken 
the second amendment is first put to 
vote, then the first amendment, and final- 
ly the motion as amended. 

It is the duty of every member present 
to vote when the vote is called for. To 
refrain from voting is simply to brand 
yourself as a woman without an opinion 
and therefore of less account than the 
chair upon which she is seated. If the 
presiding officer is assured that all the 
members are not voting, she can request 
them to vote, and each one must then 
vote or give some adequate reason why 
she is unwilling to express her opinion. 

Very frequently people attend meet- 
ings and hear motions passed of which 
they do not approve, they say nothing 



and refrain from voting. After the meet- 
ing they are apt to say, "I did not ap- 
prove of the measure, and so did not 
vote for it." They are evidently ignorant 
of the fact that all who refrain from 
voting may be counted on the prevailing 
side. 

If you are a member of any organiza- 
tion, remember it is your duty to keep 
yourself informed as to what it is doing, 
and if something is proposed of which 
you disapprove you must say so. A law- 
suit was lately brought against a 
women's organization to collect a bill, and 
the defense set up was to the intent that, 
while the vote to incur expense was car- 
ried, many members present had disap- 
proved and had refrained from voting. 
The judge ruled that this defense was 
inadequate and that the members by their 
silence had practically acquiesced. Re- 
member that at all times you are reason- 
ing human beings and that parliamentary 
law is designed to allow you to demon- 
strate that fact when you are attending a 
meeting. 



ai ^racttcal ^oint 



A CONTRIVANCE easily made, 
^ ^ and very useful in nursing cases 
where the patient is to be kept in the 
semi-recumbent or sitting position, as, for 
instance, in pneumonia, or in operations 
on the upper abdomen, is arraned by tak- 
ing a broomstick with the broom part saw- 
ed off. Wrap around this stick a blanket, 
large pillow, or something to make it re- 
semble a knee bolster. Place this undcM- 



the knees of the patient, and to each end 
of the broomstick attach a stout cord, 
which may be securely tied to the bed- 
posts at the head of the bed. This will 
add to the comfort of the patient in pre- 
venting the constant sliding down which 
is so difficult to prevent. It will also 
save the nurse a great deal of tugging 
and lifting. 

S. T. 



Snfmt jfeetiing 

( Cantinued) 
MTER SOLIS-COHEN, A.B., M.D. 



SUBSTITUTE FEEDINQ. 

A MOTHER, denying her baby its 
■*' ^ right to be provided with the 
best nourishment, may be unwilling to 
nurse it. Others who would gladly 
suckle their infants have no milk at all, 
or but a little, and that only during the 
first weeks after confinement. Some- 
times after flowing freely for i^everal 
months, the milk suddenly stops. Certain 
conditions in the mother may render her 
unable to nurse her child. When she is 
ill, when her milk disagrees with the 
baby, when she becomes pregnant again, 
and when her system is being drained 
and her health injured by prolonged lac- 
tation, the child should be removed from 
the breast. In all these cases, and when 
the mother dies, resort must be had to 
substitute feeding. 

Human milk, which unquestionably is 
the best food for a baby, may still be 
givea by the employment of a wet- 
nurse. 

The Wet Nurse. — The choice of a 
wet nurse is a most important matter. 
The woman must be strong and perfect- 
ly healthy, and should have well-shaped 
nipples and firm breasts containmg an 
abundant supply of milk. Personal 
qualities should also be taken into con- 
sideration. The wet nurse should be 
even tempered, amiable, temperate and 
reliable. She should suckle only her 
foster-child. Her life and diet should 
be regulated according to the hygienic 
rules laid down for the nursing mother. 

Substitutes for Human Milk. — Where 
it is impossible to employ a wet nurse 



some substitute for human milk must be 
provided. Both ass's milk and mare's 
milk resemble human milk ; but they 
rarely can be obtained and they are 
likely to be very expensive. The milk 
of the goat is more like that of the cow 
and has little advantage over it. Cow's 
milk, being most easily procured, is 
the substitute generally employed. In 
its natural state, however, it is unsuited 
to the baby's digestion. Therefore, be- 
fore it can be given to an infant, it must 
be modified so as to resemble human 
milk. 

Modified Coiv's Milk. — There are 
many different methods of modifying 
cow's milk. With the more common of 
these, and with the reasons for em- 
ploying them, a nurse should be fa- 
miliar, so that she will be able to pre- 
pare bottles for any physician and to 
understand the principles or theories un- 
derlying the modification he directs. The 
object sought is always to follow nature 
as closely as possible and to provide a 
food that resembles human milk in its 
nutritive value, in its behavior in the 
infant's digestive tract, and in the man- 
ner and condition in which it is supplied 
to the child. 

Cow's milk diflfers from human milk 
in many ways, chemically, physiologi- 
cally and bacteriologically. The chief 
difference lies in the character of its 
proteid, which in the one is especially 
adapted to the digestive tract of a child 
and in the other to that of a calf. To 
appreciate this diflFerencc it will be nec- 
essary to refer to the chemistry of the 



THE TRAINED NURSE AND HOSPTrAL REVIEW 



19 



protcid, to the process of digestion and 
to the development of the digestive 
tract. 

The Difference in the Digestion of 
Cow's Milk and Human Milk. — The 
stomach secretes rennet, hydrochloric 
acid, and pepsin. 

There are two kinds of proteids in 
milk, one that forms curds, known as 
casein, and a portion remaining always 
soluble called albumin. The albumin is 
not affected by chemicals ; moreover, it 
is readily absorbed from the alimentary 
tract without undergoing further diges- 
tion. The casein, on the other hand, 
forms chemical compounds with both 
acids and alkalies. In fresh milk, casein 
is always in combination with lime or 
calcium, forming calcium casein. This 
calcium casein when acted on by rennet 
in a weakly acid medium is changed 
into calcium paracasein or junket clot. 
(Junket, or curds and whey, the familiar 
dessert, is cow's milk in which the 
casein has been changed into paracasein 
by the action of rennet.) The curd thus 
formed differs in its character, depend- 
ing on the kind of milk acted upon. The 
milk of animals, such as the cow, whose 
digestion takes place principally in the 
stomach, curdles in large solid masses, 
which cannot easily leave the stomach 
until digested. The milk of a woman, 
whose digestion occurs partly in the 
stomach, and partly in the intestines, 
forms finely divided, flocculent curds, 
which are ready to be passed into the 
intestines at once. 

These paracasein curds formed by the 
action of rennet are not themselves 
acted upon by pepsin. They do com- 
bine, however, with hydrochloric acid 
to form chlorid of paracasein, a com- 
pound which is readily acted upon by 



pepsin. This new compound, chlorid of 
paracasein, also assumes a different 
character in cow's milk and in human 
milk. In the former it occurs as large, 
tough curds; in mother's milk, on the 
contrary, the curds are small and floccu- 
lent. 

The Development of the Digestive 
Tract. — At birth an animal's digestive 
system is not fully developed. The col- 
ostrum, which is the first food to enter 
the stomach, requires little digestion, 
as it contains no casein and hence forms 
no curds. Consequently, at first the 
stomach secretes little digestive juices. 
Later, as the milk begins to displace the 
colostrum, the digestive juices begin to 
appear and the stomach and intestines 
gradually assume their functions. Hum- 
an milk is eminently fitted for the de- 
velopment of the baby's digestive sys- 
tem, of which the intestines are the 
most important part. Cow's milk, on 
the other hand, is primarily intended to 
nourish and to develop the digestive 
tract of a calf that grows and develops 
much more rapidly than a baby, and, 
consequently, requires more proteid.^ 
This proteid of cow's milk being intend- 
ed for digestion in the stomach, forms 
large, solid curds that cannot readily 
leave that organ. Consequently, before 
cow's milk can be used for infant feed- 
ing it must undergo some modification 
that it may be adapted to the needs of 
an infant whose digestion takes place 
principally in the intestines. 

How to Alter the Character of the 
Casein. — The casein in cow's milk may 
be altered chemically or mechanically. 
It will be recalled that rennet acts on 
calcium casein only in the presence of 
a weak acid. Consequently the addition 
(jf an alkali, such as lime-water or sodi- 



20 



THE TRAINED NURSE AND HOSPITAL REVIEW 



um bicarbonate, will prevent the forma- 
tion of any curd at all until the alkali 
has been neutralized by the acid in the 
stomach. While this neutralization is 
going on part of the uncurdled milk- 
escapes into the intestines to be digested 
there. By varying the quantity or 
strength of the alkali added we can reg- 
ulate the amount of work to be done 
by the stomach. A small proportion 
of alkali will permit the greater part of 
the milk to be digested in the stomach ; 
a large amount will throw all the work 
on the intestines, relieving the stomach 
entirely. The alkalies, however, have a 
further action. They themselves enter 
into combination with the calcium case- 
in, forming basic calcium casein. Sodi- 
um bicarbonate, moreover, is what is 
called an antacid, any excess present 
serving to neutralize the acid that is 
secreted by the stomach. 

Citrate of soda is thought to unite 
with the calcium casein of milk to form 
sodium casein, a compound that will 
not form a curd when acted upon by 
rennet. Consequently milk to which so- 
dium citrate is added is believed to re- 
main fluid in the stomach. Recent in- 
vestigations have demonstrated that 
probably sodium citrate has the same 
action as a like amount of sodium chlo- 
rid or table salt. 

Tlie lactic acid present in fully soured 
milk and buttermilk combines with cal- 
cium casein to form lactate of casein, 
which appears as a soft, friable, easily 
digested curd that is not changed by 
rennet. 

The giving of casein may be avoided 
entirely by feeding whey, the proteid of 
which is in the form of albumin, that 
jwrtion of the proteid that is not acted 
upon by rennet and fails to curdle. 



The character of the curds formed by 
rennet may be modified mechanically by 
diluting the milk with decoctions of the 
cereals, such as gruels and dextrinized 
gruels. When the milk is thus treated 
the curds formed by the action of rennet 
become soft and flocculent. Even di- 
luting with plain water tends to render 
the curds less tough and large. 

Chemical Differences Betiveen Hum- 
an and Cow's Milk. — Not only does the 
proteid of cow's milk differ from that 
of human milk in its physiological char- 
acteristics, but it is present in a much 
larger amount. It will be recalled that 
human breast milk contains only about 
one and a half per cent of proteid. In 
cow's milk, on the other hand, the pro- 
teid is as high as three and a half per 
cent. Consequently, in feeding an in- 
fant cow's milk some method must be 
devised for reducing the amount of the 
proteid. There is less sugar in cow's 
milk than in human milk. The fats are 
the same. A comparative analysis of 
human milk and cow's milk shows the 
following: 



Pc. of Pc. of 

Pc. of Pc. of Pro. MIn'l 

Fat. Sngar. telds. Mat'r. 

Human milk. 4.00 7.00 i.t^o 0.20 
Cow's milk. . 4.00 



1.50 
475 350 0.70 

Bacteriological Differences Betiveen 
Human and Cozt/s Milk — Human breast 
milk is free from bacteria and their 
poisons. Cow's milk, as ordinarily 
found in the market, is loaded with bac- 
teria, the number depending on the care 
with which it is collected and handled. 
It is these bacteria and their poisons 
that are largely responsible for Sum- 
mer complaint and the intestinal dis- 
orders of infancy. Herein lies one of 
the principal reasons for the undeniable 
superiority of breast feeding over bottle 
feeding. Naturally, before giving a bot- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



21 



lie to a baby means must be taken to 
prevent or destroy these bacteria. 

The Preparation of the Bottle. — The 
principles of modified milk feeding just 
explained are utilized in preparing the 
baby's bottle. As to the exact measures 
to be employed in modifying the milk 
opinions differ even among distinguished 
]jediatrists. A nurse must be acquainted 
with the various methods and be able 
to put them into practice intelligently. 
When nursing under a physician she 
should have no opinion of her own, but 
must follow out the attendant's orders 
faithfully and conscientiously. She sup- 
])lements the physician who alone is re- 
sponsible for the feeding. He is sup- 
posed to know, and so far as the nurse 
is concerned he does know. Any criti- 
cism expressed, or implied, or even sug- 
gested by look or manner, whether in 
the presence or absence of the physi- 
cian, totally unfits a nurse for her 
proper sphere of carrying out that part 
of the physician's treatment which he is 
unable personally to attend to. 

The Milk Supply. — No matter what 
method of modifying the milk is adopt- 
ed, certain things are always necessary. 
It is of the greatest importance that the 
milk should be pure, fresh and germ- 
free. Germs or bacteria get into the 
milk with dust and dirt during milking, 
and from dirty utensils after milking. 
They can be kept out of milk to a great 
extent by absolute cleanliness of cows, 
stable and milkers, and by rapidly cool- 
in;L,' the milk and keeping it cool. 

The stable must be well ventilated, 
lighted and drained and kept clean. The 
room in which the cows are milked 
should not have feed stored in or above 
it. The cows should be kept well groomed 
and before each milking should be care- 



fully wiped with damp cloths. The milk- 
ers should wear fresh, clean clothes, 
preferably of washable linen or duck, 
and before milking should scrub their 
hands thoroughly with soap and warm 
water and dry them on a clean towel. 
The milk pails must be scrupulously 
clean, best sterilized. The first few 
streams from each teat should be dis- 
carded, as they usually contain bacteria. 
The milk of each cow as soon as ob- 
tained should be immediately removed 
from the stable to a clean room and 
there rapidly cooled. It then should be 
bottled at once in sterilized bottles. 

All dairymen are not willing to ob- 
serve the directions just enumerated. 
One, therefore, should purchase milk 
only from reliable milk dealers who 
are known to supply good and pure 
milk. In many cities medical societies 
issue certificates to all dairies conform- 
ing to their rules and whose milk when- 
ever examined shows the proper rich- 
ness and freedom from bacteria. This 
milk is known as "certified" or "in- 
spected" milk, and although more ex- 
pensive than milk not certified to is 
much safer. When the milk cannot be 
kept cool and when it cannot be de- 
livered before it is at least twenty-four 
hours old, it should be pasteurized or 
sterilized on the farm after bottling. 
This will destroy any germs present in 
it. But such milk when once exposed 
to the air becomes contaminated much 
sooner than fresh milk not so treated, 
because the sterilization and pasteuriza- 
tion kill not only the dangerous germs 
but also certain bacteria whose function 
is to fight the dangerous organisms. 

Selection and Care of Bottles and 
Nipples. — The nursing bottle should be 



22 



THE TRAINED NURSE AND HOSPITAL REVIEW 



smooth inside and without angles or 
depressions, so that it may be easily 
cleansed. As soon as the baby has 
finished with it, the bottle must be 
emptied of any milk that remains, 
rinsed well and placed in a strong solu- 



tion of washing soda and water. Every 
evening the bottles should be removed 
from this solution and scrubbed inside 
with a bristle brush. In the morning, 
just before being filled, they should be 
boiled. 



(To be continued.) 



iLittle 3^ai>monD 

BERTUA E. MERRILL. 



TT E was eight years old, and, although 
-'■-'■ the street corners and alley ways 
had been his playground, he was sin- 
gularly free from the coarseness of 
speech and manner that such environ- 
ments usually bring. His nature seemed 
to have gathered endurance and inde- 
pendence from the life he had known 
without absorbing the dross ; at the same 
time keeping a childish faith and sim- 
plicity that made him very attractive. 

He was his widowed mother's help 
and comfort, and it was while on an er- 
rand for her that, in getting off the 
street car, he had slipped and the merci- 
less wheels had made him a cripple for 
life. 

His courage and patience during the 
long weeks of suffering, and his quaint 
remarks, endeared him to every nurse in 
the ward. We all dreaded the time when 
he must be told of the calamity that had 
overtaken him, but when it had been 
gently told him he looked down at his 
remaining leg, still discolored from the 
bruises, and said in a low, awestricken 
voice, "Wouldn't I have been in a dread- 
ful fix if I'd lost 'em both?" 



Christmas, with all its mysteries and 
festivities, was drawing near, and in the 
children's ward there were many plans, 
speculations and anticipations. Christmas 
eve, as I was putting the ward in order 
for the night, he called me to his bed- 
side, and, giving me a couple of toys 
that some one had brought him that 
afternoon, requested that they be put on 
the floor under his bed, "just as near the 
middle of the bed as you can," he said. 
"Let me arrange them nicely on this 
table at the head of your bed," I sug- 
gested. "Under the bed is not a good 
place for new toys." "No, no," he plead- 
ed. "Please, Miss M., put them under 
the bed, just as near the middle as you 
can, and then come here and let me 
whisper the reason why." I complied 
with his request, and he drew my head 
down to his face and whispered : "Don't 
you see, if Santa Claus were to come in 
the night and see those new presents on 
the table he would say to himself, 'Why, 
I must have been to this little boy before 
to-night,' and he would go away and 
never leave me a thing." 



33actertolosp 

CLARA FOSTER, R. N. 

{Continued fj-otn December.^ 



AMONG the bacilli, those of the 
greatest surgical interest are: 

The Bacillus Pyocyaneus, which is the 
cause of the green or blue color which 
we sometimes see on dressings satura- 
ted with pus. Fortunately this bacillus 
is not as dangerous as its appearance 
leads us to suppose. We read that "in 
hospitals true epidemics of blue pus 
have been observed.'' 

The Bacillus Tuberculosis was discov- 
ered by Robert Koch, and may be re- 
garded as one of the greatest medical 
discoveries of the age. It is a small 
slender rod, possessing no ipower of 
motion. It stains easily by several 
methods, but it is almost impossible to 
discolorize the cells. This, and its great 
power of resistance, form its chief dis- 
tinguishing characteristics. It is this 
bacillus which is the cause of tubercu- 
losis of the lungs, and there is not a 
tissue in the body which may net be- 
come the primary seat of tuberculosis. 
The bacillus is found in all tubercular 
tissue and in the sputum of all tubercu- 
lous patients. It is also found in milk, 
butter, and in meat from tuberculous 
animals. The milk from tuberculous 
cows may be a means of transmitting 
the disease. Local tuberculosis has been 
known to follow direct inoculation of 
wounds, but this is rare. 

The most common means of infection 
is by the inhalation of air ladeti with 
dried tubercular expectoration. It is 
found wherever human beings are 
crowded together, in the dust of streets, 
vehicles, rooms, etc. Tlie bacilli con- 



tained in the sputum of tuberculous 
patients are very resistant to all forms of 
disinfection. Formaiin and bichlor ot 
Mer. kills them after a short time, but 
they will resist a five per cent sol. of 
carboHc acid for hours. Burning, before 
it is dry, is the only safe way of dispos- 
ing of the sputum of tuberculous pa- 
tients, or of anything with which it has 
come in contact. The culture die quick- 
ly in sunlight, and we learn that Koch 
saw them die out in from five to seven 
days by simply placing them at a win- 
dow. 

In view of these facts, too much 
stress cannot be laid upon the necessity 
of pure air and sunlight, and the need 
of absolute cleanliness. If it is borne in 
mind that at least one-seventh of the 
human race succumb to some form of 
tuberculosis, a slight idea may be gained 
of the importance of this bacillus and 
the need of general knowledge as to its 
method of dissemination. 

The Bacillus Tetani. — Specific cause 
of lockjaw, is a rod-shaped organism, 
sometimes short, sometimes occurring in 
long threads and occasionally forming 
chains. The spores arc very resistant to 
heat, and six days' exposure to direct 
sunlight is necessary to kill them. It is 
found in garden soil, in the feces of her- 
bivorous animals, in hay, dust, etc. It 
has been found in cartridges and on cob- 
webs. In disease it is found in the in- 
fected wound, which is usually purulent. 
Tetanus may follow any wound, how- 
ever slight, but is more likely to follow 
a deep punctured wound, such as tho.?e 



24 



THE TRAINED NURSE AND HOSPITAL REVIEW 



made by nails or splinters, especially if 
allowed to close early. This is an anaero- 
bic microbe and cannot grow where there 
is oxygen. The necessity, therefore, of 
thoroughly cleansing all wounds, and the 
risk incurred in closing them with collo- 
dion, adhesive plaster, etc., is plainly ap- 
parent. This disease was far more pre- 
valent before the days of asepsis and 
antisepsis. 

The Bacillus Anthracis or Anthrax 
bacillus has the distinction of being prac- 
tically the first pathogenic microbe to be 
isolated ; also, the spores are the most 
resistant to heat of any known. It is a 
large rod, often found in pairs, or chains. 
It is found only where diseased animals 
have been. In man it is frequently fatal, 
appearing first as a small carbuncle, and 
from this, rapid general infection ensues. 
All the glands of the body become en- 
larged and many of them suppurate. It 
frequently destroys large herds of cattle 
in European countries, but in the United 
States we have only isolated cases whose 
origin can usually be traced to hides or 
hair, imported from abroad. 

The Bacillus of Malignant Edema is 
a thickish rod resembling the bacilli of 
tetanus and anthrax, and, like them, it is 
a strictly anaerobic organism. If applied 
to a scratched surface, infection is not 
likely to occur, the free oxygen seeming 
to prevent its growth, but if the wound 
is deep, a most rapid infection may take 
place. It is found in soil, dust, manure 
and dirty water. The disease is almost 
always quickly fatal in man, but fortu- 
nately it is not often met with. One 
case only has come under the observa- 
tion of the writer in which infection fol- 
lowed a slight surgical operation, prob- 
ably performed without due regard to 
aseptic precautions, and the patient, a 



strong man, after running a temperature 
of 107 degrees, died within forty-eight 
hours. 

One of the most interesting of the 
non-pathogenic bacilli is the Bacillus 
Prodigiosus, which is found sometimes 
on moist bread, potatoes, and in milk. Its 
cultures produce a red color, which fact 
has, in the far away past, been responsi- 
ble for certain legends of "bleeding 
bread," "bleeding wafers," etc. 

So far, we have been considering the 
bacteria most important from a surgical 
standpoint, as these chiefly concern the 
nurse in her work of prevention and ap- 
plication of aseptic principles. Coming 
briefly to some of the known organisms 
that cause acute infectious diseases, we 
find : 

The Typhoid Bacillus. — Generally 
short, plump rods, forming long threads 
in cultures. They are never found in 
nature except when the soil or water has 
been contatninated by feces or urine. 
They will remain alive in ice for months. 
In disease they are found in the stools 
and urine and in the blood. They invade 
the body by way of the alimentary tract, 
in food and water. Flies may very easily 
infect food. Oysters may become in- 
fected in water that has been contaminat- 
ed and so become a means of conveying 
the disease. In fatal cases, death is pro- 
duced either by profound general poison- 
ing to the system, by ulceration of Peyers 
patches, causing perforation and peri- 
tonitis, or by the destruction of a blood 
vessel in the floor of an ulcer, causing 
hemorrhage. Knowing the nature of the 
foe with which she has to deal, and the 
ease with which this dreaded disease may 
be transmitted, the nurse who watches a 
case will realize that "eternal vigilance" 
and absolute thoroughness in the use of 



THE TRAINED NURSE AND HOSPITAL REVIEW 



25 



disinfectants is the only price of safety 
for herself and others. 

The Colon Bacillus, which much re- 
sembles typhoid, is found in the intes- 
tines of most animals and man; also 
found in streams, wells and springs 
which are near towns or farm lands. 
While it is difficult to find typhoid in 
drinking water, the colon is easily found. 
It plays an important part in secondary 
infection, and is a factor in suppurative 
peritonitis, though not the only cause of 
it. Is often found in company with the 
Streptococcus. Has been known to cause 
epidemic of diarrhoea in institutions. 

Perhaps the Bacillus of Diphtheria 
(Klebs Loeffler bacillus) should have 
been included in the previous section, as 
it is, without doubt, capable of causing 
local infection by means of abrasions of 
the skin or mucous membrane in any 
part of the body. It is a bent or curved 
bacillus of irregular shape, and differing 
much in length. It will live for months 
in a dried condition. Formalin vapor 
kills it, also corrosive sublimate solution. 
In disease it is found mostly in the throat, 
and may remain alive in the throats of 
healthy persons for months. Diphtheria 
is usually spread by contact with those 
suffering from the disease, and with con- 
valescents in whose throats the bacilli 
remain alive. The rapid growth of the 
bacilli in the test ube makes the diagnosis 
of diphtheria from culture comparative- 
ly easy. A sterile swab of cotton is 
rubbed over the false membrane in the 
throat and then over the serum in the 
test tube; the tube is placed in the in- 
cubator, and after from eight to ten 
hours the serum is covered with fine 
granular colonies of pure diphtheria 
bacilli. Since the discovery of diphtheria 
antitoxin, the death rate from this dis- 



ease has been wonderfully lessened, and 
it is no longer greatly to be feared, if 
the antitoxin is used early. 

It is the plain duty of the nurse to 
use any influence she may possess to 
secure its use in any case of diphtheria 
with which she comes in contact. While 
the doctor may, and usually does, decide 
the question, he still encounters, many 
times, the most astonishing and unrea- 
sonable prejudice against this wonderful 
remedy — prejudice, due chiefly, we think, 
to attributing to the use of antitoxin the 
toxic effects, as heart failure, paraly- 
sis, etc., produced by the specific poison 
of the disease. Pittfield says : "If there 
is one natural specific cure for any dis- 
ease, it is diphtheritic antitoxin serum. 
No case is too trivial or too far advanced 
in which to use it." 

The Pneumococcus or Diplococcus 
Lanceolatus, a lancet-shaped, encapsulat- 
ed microbe, is generally conceded to be 
the cause of pneumonia. Besides its fa- 
vorite seat in the lungs, any serous 
membrane may be attacked, causing 
meningitis, endocarditis or peritonitis. 
Abscesses anywhere may be due to this 
microbe. It is also found in the sputa 
of healthy individuals, on the conjunc- 
tiva, and in the nose. Has never been 
found outside the human body. 

The specific microbe of scarlet fever 
has not been isolated, but it is very 
tenacious. Infected clothes laid aside 
for years have been known to cause out- 
breaks of the disease. It is contagious 
at all periods, but most so during the 
period of desquamation, and the skin is 
supposed to be the chief seat of the 
organism causing it. 

The Streptococcus Pyogenes plays an 
active part in all these last-named dis- 
eases, and in diphtheria and tuberculo- 



26 



THE TRAINED NURSE AND HOSPITAL REVIEW 



sis as well. It causes an aggravation of 
the original infection, and often death. 

While most diseases are caused by 
vegetable parasites such as we have been 
considering, there are others caused by 
minute organisms of the animal king- 
dom. These animal parasites or Proto- 
zoa are the cause of several well known 
diseases, notably malaria, yellow fever 
and dysentery. 

In hydrophobia, smallpox and scarlet 
fever, certain organisms are constantly 
found that resemble the protozoa, but 
the exact knowledge that they are the 
cause of the disease is still lacking. 

It has been positively demonstrated 
that the Anopheles Mosquito acts as the 
intermediate host of the malarial para- 
site, and that infection in man follows 
the bite of the infected insect. The 
freshly formed organism in the blood of 
the man is coveyed into the intestines of 
the mosquito, where it undergoes a dif- 
ferent cycle of development and finally 
finds its way, by means of the circula- 
tion, into the salivary glands. From 
thence by the bite of the mosquito it is 
transferred to the blood of the new 
victim. To prevent the spread of ma- 
laria, mosquitoes must be exterminated, 
or at least prevented from reaching those 
suffering from the disease and convey- 
ing it to others. Screens are the best 



means of effecting this. The larva of 
the mosquito develops in stagnant water, 
and all pools that cannot be drained 
should be covered with oil, which quickly 
destroys the larva. 

Probably most nurses are familiar with 
the heroic work done by Dr. Reed and 
his assistants in 1900, by which it was 
at last clearly established that the mos- 
quito is the intermediate host of yel- 
low fever. Though the specific parasite 
of the disease has not been found and is 
supposed to be submicroscopic, there re- 
mains not a doubt that it is transferred 
from one patient to another by means 
of the mosquito Stegomyia Fasciata. 
Without this mosquito there can be no 
yellow fever, and the spread of the 
disease may be prevented by destroying 
them and preventing their access to yel- 
low fever patients, and from them to 
the non-immune. The splendid results 
of work based upon these facts during 
the late yellow fever epidemic in New 
Orleans are well known. Any nurse 
who is interested in these investigations 
(and all nurses should be) and has not 
read Dr. Kelly's "Walter Reed and Yel- 
low Fever,"* is advised to do so at once, 
for a more inspiring record of patient 
effort, self-sacrifice and achievement for 
the good of humanity does not exist in 
all the annals of medical research. 



Women Nurses for Navy. 



Dr. R. W. Plumtner, assistant surgeon of 
the United States naval medical service, who 
spoke December 10 at the opening session of 
the National Legislative Council of the Am- 
erican Medical Association in the Auditorium 
Hotel, Chicago, said that "in order to raise 
the United States naval medical service to 
its highest standard of eflBciency women nurses 
should be employed. 

"Women nurses are best," the speaker said. 



"The army has them and the reports from 
the army surgeons show that the medical serv- 
ice has been raised to a higher standard." 

A bill for the establishment and organiza- 
tion of a corps of trained women nurses for 
the navy, he said, will be recommended to 
Congress at the present session, providing 
that women nurses be employed in naval hos- 
pitals on shore in time of peace and on hos- 
pital and ambulance ships in time of war. 



•For sale by Lakeside Pub. Co. Price, $1.50, postpaid. 



pensions for armp jBturses 



ANITA NEWCOMB M'GEE. 



"PENSIONS '^for army nurses must 
■*• necessarily conform to our general 
pension system. This has steadily grown 
from modest beginnings until now it 
has extended far beyond anything known 
in other countries. In 1905 over $139,- 
000,000 was paid to about 1,000,000 pen- 
sioners, besides which thousands are sup- 
ported in soldiers' homes. The new 
law, of last February, has made possible 
a great increase- in these figures, which 
otherwise would diminish by reason of 
many deaths of pensioners. 

Although special allowances and 
bounties were early given, the first pen- 
sion law was not passed until 1818. It 
allowed three dollars a month to such 
survivors of the Revolutionary army as 
were in need of financial aid, provided 
they had served nine months, which was 
quite a long period as Revolutionary en- 
listments went. As almost 19,000 for- 
mer soldiers applied. Congress became 
alarmed at the sum required and ordered 
that none whose property exceeded $150 
should be placed on the rolls. After that 
the increase in liberality was slow until 
the Civil war, when the political influence 
of the large "soldier vote" began to show 
its power. The present situation as re- 
gards Civil war soldiers of the Union 
army has thus been stated by the Interior 
1 )c])artment : 

"Under the general law any soldier 
who served in the Federal army in the 
Civil war was honorably discharged, and 
if disabled by wounds received or disease 
contracted in the line of duty in such 
service, is pensionable regardless of the 
length of time he served. 



"Under the act of 1890, any soldier 
who served in the Federal army in the 
Civil war not less than ninety days, was 
honorably discharged, and since his dis- 
charge, by accident or disease not due to 
his own vicious habits, has become in 
any degree unable to earn his support 
by manual labor, is entitled to pension, 

"Under the act of February 6, 1907, 
any soldier who served in the Federal 
army in the Civil war ninety days, and 
was honorably discharged, is entitled to 
pension at the rate of $12 a month after 
he has reached the age of sixty-two 
years, $15 a month after he has arrived 
at the age of seventy, and $20 a month 
after he is seventy-five years old, on ac- 
count of age alone." 

It is unnecessary in this article to con- 
sider laws regarding widows and other 
dependents, except to mention that the 
usual widow's pension is $8 a month. 
Army nurses, in whom we are most in- 
terested, were not recognized as pen- 
sionable until long years after the Civil 
war, in which they served. Finally, in 
1892, so many of them had become de- 
pendent that they and their friends 
urged Congress to provide for them in 
their old age, and a law was passed 
granting $12 a month to women nurses, 
under the following conditions : They 
must have been actually employed as 
nurses by authority of the War Depart- 
ment ; have served in the Civil war and 
in hospitals belonging to the army ; actu- 
ally nursed during at least six months ; 
have been honorably discharged, and be 
now unable to earn a support, but that 
inability need not be otherwise proved 



28 



THE TRAINED NURSE AND HOSPITAL REVIEW 



to the Pension Office if the applicant is 
over sixty-five years old. Efforts were 
made last winter to increase the amount 
of these pensions, but they failed. So did 
an attempt to pension the so-called "vol- 
unteer nurses," who were not employed, 
and of whom the War Department has 
no record, because of the impossibility 
of obtaining conclusive evidence regard- 
ing their number or services. 

This statement about Civil war pen- 
sions shows that there are two distinct 
classes of persons who receive them be- 
cause of their own services. First : Those 
officers, soldiers and sailors with some 
permanent disability directly due to 
wounds or disease incurred in line of 
duty, regardless of any other condition. 
Second : Those who served at least nine- 
ty days (or six months, if nurses), and 
whose age (or post-service disability) 
entitle them to consideration. 

Veterans of the Spanish war are en- 
titled only to the first class of pensions. 

Nurses of the Civil war are entitled 
only to the second class of pensions. 

What class should the Spanish war 
nurses have? As veterans of that recent 
war will doubtless have to wait many 
a year before getting the second class of 
pensions, for age alone (if indeed they 
ever do), and as the Civil war nurses 
waited twenty-eight years for theirs, it 
is clear that the Spanish war nurses 
need waste no time at present hoping 
for pensions based on age or recent dis- 
ability alone. The only thing to con- 
sider now is what the Spanish war vet- 
erans have, viz., the pension for per- 
manent disease actually incurred in the 
service. 

But there is no general precedent for 
pensioning women in this way, and in 
the minds of members of Congress there 



are weighty reasons against such a 
breaking of barriers as this would mean. 
For another thing, the important dis- 
tinction involved in a technical "com- 
mission" or "enlistment" must be up- 
held, they say. True, acting assistant, or 
contract, surgeons have pensions in spite 
of that, but the telegraphers, the dentists, 
the quartermaster employes and some 
others attached to the army are unable 
to get laws passed in their favor. An- 
other objection to general legislation for 
army nurse pensions is that not enough 
of them, in or since 1898, have been 
permanently disabled in line of duty. The 
efforts of the Pension Committee of the 
Spanish-American War Nurses have re- 
sulted in the discovery of scarcely half 
a dozen claimants, and at date of writ- 
ing only one has obtained complete evi- 
dence of her claim! To obtain the 
passage of a general law is quite a seri- 
ous undertaking, and no consideration 
could be had in this case unless a large 
number were in need of it. Note, by 
way of contrast, that there were, recent- 
ly, on the pension rolls 587 army nurses 
mainly pensioned under the Civil war 
nurses' act above defined, though a num- 
ber benefit by special acts in their favor. 
As to the Spanish war veterans, they are 
so numerous that up to June 30, 1906, 
$15,500,000 had been paid to them in dis- 
ability pensions, and to 660 of their 
widows. 

What has just been said does not in 
the least mean that pensions for Sjjanish 
war nurses cannot be obtained, for there 
are two ways of securing them. The one 
spoken of above is by a general act, 
affecting people as members of a class. 
The other is by what is called a "special 
act" for the benefit of an individual. 
Where there are so few persons needing 



THE TRAINED NURSE AND HOSPITAL REVIEW 



29 



relief as would appear to be the case 
among the army nurses of recent times, 
they may be cared for by such special 
acts. Before describing the method of 
obtaining these, some other general con- 
siderations need to be taken up. 

It should be clearly understood that 
our Government never goes about look- 
ing for persons who deserve its money. 
No appropriation of the kind we are con- 
sidering, however wise or just, is voted 
unless the persons to be benefited, or 
their friends, ask for it. It may be said 
they must work for it and urge it until 
enough influence is brought to bear in 
both Houses of Congress to secure the 
necessary votes for the appropriation. 
The soldiers of the Union army organ- 
ized in the Grand Army of the Republic 
and exerted all their political influence 
to obtain, and increase, the pensions to 
which their members considered them- 
selves entitled. Our pension system 
would never have grown as it has with- 
out the efforts of great numbers of sol- 
diers themselves organized in a working 
body. But, even after a general law is 
passed, the Pension Office makes no ef- 
fort to find the beneficiaries, and if any 
one of them prefers not to receive pub- 
lic aid he simply does not apply for it, 
and the receipt of pension money will 
never trouble him. 

C)riginally, as was shown at the be- 
ginning of this article, pensions were not 
at all considered as a "right," but were, 
in fact, a form of public charity, which 
was limited to soldiers who were old and 
without means of support. Wounds 
had always been considered as incidents 
(»f a soldier's service which he took on 
himself when he enlisted, just as he took 
other chatices through life. A point to 
remember is the difference l)etween a 



moral and a legal right to a benefit. The 
former is partly a matter of opinion ; the 
latter is wholly a matter of exact law. 
In general, the former must precede the 
latter, for all law is 'based on public 
opinion. Opinions regarding the duty of 
a country toward its citizens are grow- 
ing broader as the centuries pass, and 
such ideas as retirements and pensions 
for the military, and also for civilian 
employes of the Government, are ever 
growing more popular here. But to put 
into effect these generous ideas the peo- 
ple must be willing to pay the bills, and 
members of Congress, who are custodi- 
ans of the people's money, must know of 
their willingness. What "bringing influ- 
ence" in these matters means is the prov- 
ing to members of Congress that if they 
vote a certain appropriation it will have 
the approval of citizens of our country, 
who pay the taxes ! Now, they may not 
be certain of this without being told, and 
if the appropriation is a large one, as in 
the case of general pension laws, many 
citizens must "influence" many members 
so as to make the force of public opin- 
ion felt. On the other hand, in the case of 
a small appropriation such as is required 
in a "special act" for an individual, there 
is no need for this extensive action, and 
that is why it is so much easier to have 
several special acts passed than to pass 
one general one. 

But it is evident that while public 
opinion will sustain appropriations for 
individual army nurses in need, it hesi- 
tates to grant them the general pension 
privileges of soldiers because of the great 
difference in the risks which they run. 
Unless in an altogether extraordinary 
case, nurses are not wounded. Nor arc 
they obliged to take the forced marches 



30 



THE TRAINED NURSE AND HOSPITAL REVIEW 



or endure the excessive privations of an 
army on the move in active campaign. 
Some hardships they undoubtedly en- 
dure, and risks of camp diseases they 
undoubtedly run, but beyond all ques- 
tion, speaking of wars in general, these 
are less than those of a soldier. Beyond 
question, this is a most important reason 
why Congress has not pensioned nurses 
the same as soldiers, and why in the 
case of the Civil war nurses it required 
twice the length of service of them that 
it did of the men. 

This matter of risks taken is put in 
another way by one of the Spanish war 
nurses who wrote that she will help 
work for a pension for a nurse whose 
health was unquestionably injured in her 
army service, but at the same time she 
personally feels "we only did our duty. 
I have risked my health oftener on pri- 
vate duty than in the army; yes, and 
have gone hungry because the food was 
not cooked properly. Yet I would not 
think of asking a family to give me any- 
thing because my health was gone. I 



was sick for six months after nursing 
scarlet fever, yet that is what we risk. 
* * * Hope you understand from 
this that those who really are suffering 
I want to help, and my expressions are 
of nursing risks in general." 

While this view is doubtless correct 
in the main, there are certainly cases in 
which it is not correct at all, as the 
writer implies. For example, nurses who 
went to Cuba, the Philippine Islands and 
other Southern climates, ran risks of 
diseases they could not have contracted 
at home, and some are now suffering 
from these disorders. Such an excep- 
tional danger, too, was the remarkable 
tidal wave which flooded the camp at 
Fernandina, Florida, and obliged the 
nurses there to work for many hours in 
their wet clothing. Yes, beyond all ques- 
tion, the nurses who were permanently 
disabled in line of duty deserve pensions 
as much as any soldier, and since general 
legislation to that effect cannot now be 
obtained, we turn to the opportunity for 
special provisions in their favor. 



(To be Continued.) 



Graduated Nurses of Texas. 



Miss Maline Smith has returned to her home 
in Galveston from Panama, where she has 
been nursing for the past year. 

Miss Fannie Roberts has resumed her work 
in Waco after a much-needed rest. 

Miss Gabriel, of Fort Worth, is in Colorado 
with a patient. 

Miss J. S. Cottle has returned from Zanes- 
ville, Ohio, where she has had charge of a 
hospital this Summer, and is doing private 
nursing in Fort Worth. 

Miss A. Alschier, of Dallas, will spend the 
Winter in Mexico with her sister. 



Dr. and Mrs. W. C. Mayes (nee Lunny) 
have gone to Colorado for the benefit of Dr. 
Mayes's health. 

Miss C. Van Dorcn, of Belton, spent several 
weeks in Colorado this Summer with a 
patient. 

Miss E. W. Hill, of San Antonio, expects 
to leave in a short time for Mexico, where 
she will take charge of a hospital. 

Will the Texas nurse whose article ap- 
peared in the May number kindly send me her 
address? C. Van Doren, Secretary, 

Belton, Texas. 



(i^uestionjs of J^utses' Coraminitts 3BciarD of tlje 
i9t£itttct of Columiita 



ANATOMY, PHYSIOLOGY AND HYGIENE. 

(i) Name organs of digestion? 

(2) Locate ileum and ilium? 

(3) What is the pleura, periosteum, 

perineum, tympanum and cor- 
nea? 

(4) What is the medulla oblongata ? 

(5) Name largest gland, and state its 

chief function? 

(6) Describe circulation in a general 

way, or the process of digestion ? 

(7) How are waste products elimin- 

ated from the body? 

(8) State function of red corpuscles? 

(9) What are the hygienic essentials 

of a sickroom? 
(10) How would you dispose of 
sputum ? 

MEDICAL NURSING AND BMBRGBNGIBS. 

(i) Mention three kinds of enemata, 
and distinction in the giving of 
each ? 

(2) Give symptoms of hemorrhage in 

typhoid fever, and state care of 
patient until the arrival of ph) - 
sician ? 

(3) State points to be noted in taking 

the pulse and respiration? 

(4) What immediate treatment should 

be given in severe burns and 
scalds, while awaiting the arrival 
of physician? 

(5) What stimulation can be given by 

a nurse in the above case for 
shock ? 

(6) State how long patient should be 

left in hot packs, and how are 
they given? 

(7) What method should be used for 

the prevention of infection in 
fevers ? 



(8) What care should be exercised in 

nasal tube feeding? 

(9) What treatment would you give 

for morphine poisoning? 
(10) How would you treat a fainting 
person ? 

OBSTETRICS AND GYNECOLOGY. 

(i) What is the duration of preg- 
nancy; and how do you deter- 
mine the probable date of con- 
finement ? 

(2) What preparation do you consid- 

er necessary for an approaching 
confinement? And what neces- 
sary preparation would you make 
immediately preceding labour? 

(3) How many stages of labour are 

there ? And state when each be- 
gins and ends? 

(4) What care would you give the 

nipples before and after confine- 
ment? 

(5) What is colostrum, and what is 

its function? What is the func- 
tion of the amniotic fluid? 

(6) State in detail the care you would 

give an infant for the first 24 
hours after birth? 

(7) Are there any diseases from 

which you would not go to an 
obstetrical case? If so, name 
some of them? 

(8) What care would you give your 

hands and all articles used for 
patients in puerperium? 

(9) Name some of the emergencies 

that sometimes arise during the 
puerperal state, and what would 
be a nurse's duty under such 
condition ? 



32 



THE TRAINED NURSE AND HOSPITAL REVIEW 



(lo) How would you prepare a pa- 
tient for a gynecologic examina- 
tion? 

SURGERY AND CONTAGION. 

(i) a — How would you select and 
prepare the room for an ab- 
dominal section in a private 
house ? 

b — Give in detail the supplies 
needed ? 

c — How would you sterilize sup- 
plies and instruments? 

d — How would you prepare the 
patient ? 

(2) How would you prepare normal 

salt solution for hypodermocly- 
sis? 

(3) If you knew the patient was to 

take ether, how would you pre- 
pare him in the absence of any 
orders from the physician? 

(4) How would you treat post-opera- 

tive hemorrhage until the arrival 
of the physician? 

(5) What are the indications of 

shock ? Give treatment ? 

(6) What emergencies may arise dur- 

ing or after the administration of 
a general anaesthetic? How 
would you meet or prevent 
them ? 

(7) What care would you take of 

your health and person while in 
attendance on a contagious case ? 



(8) What steps would you take to 

disinfect a room in the countr\ 
after a contagious disease? 

(9) What must be done to the pa- 

tient after a contagious disease 
before he can safely come in 
contact with uninfected people? 
( 10 What solutions are best for disin- 
fecting clothes? 

MATERIA MEDICA AND DIETETICS. 

( 1 ) How may materia medica be de- 

fined? 

(2) What is opium, from what is it 

obtained, give its two principal 
alkaloids and their average 
doses ? 

(3) What are emetics, what two 

ways do they act, and give ex- 
ample of each? 

(4) a — What are infusions? 
b — What are tinctures? 

c — What are suppositories? 

(5) By what methods may drugs be 

administered ? 

(6) What are the different kinds of 

foodstuffs, and give example? 

(7) What is a proteid? 

(8) Describe the action of the gastric 

juices on food? 

(9) How would you cook rolled oats 

or wheat? 

(10) How would you make beef broth 
and beef juice? 



Des Moines Graduate Nurses. 



For the purpose of getting better acquainted 
and to meet the members of the senior classes 
of the three nurses' training schools in the 
city, Misses Luella Bristol, Estelle Campbell 
and Mabelle Baugh, president, treasurer and 
secretary of the Des Moines Graduate Nurses' 
Association, assisted by Misses Esther Bunch,* 
Edith Robinson and Minnie Dawson, very 
delightfully entertained the graduate nurses 
and hospital seniors of the city at the Metho- 



dist Hospital Graduate Nurses' Home, on Sat- 
urday evening, November 9. A dozen dif- 
ferent hospitals were represented by the sixty 
nurses, who greatly enjoyed the social hour. 

The Board of Examiners of Nurses for 
the State of Iowa on December i had issued 
566 certificates to graduates, and it is expected 
there is yet a large number who will apply 
before January i and receive the degree of 
R. N. without examination. 



Cfiristmas Winijtx ©uaranttne 



LILLIAN M. SQUIRE. 



A T a quarter past eight o'clock in the 
-'■ ^ morning the telephone rings sharp- 
ly. Instinctively Nurse Cameron listens 
as the matron of the Nurses' Home re- 
plies: "Yes, Dr. Martyn, Nurse Cam- 
eron is at liberty. Certainly, doctor. 
Just one moment; I will see whether 
she is in." 

Miss Cameron comes reluctantly to 
the telephone, for she has a presentiment 
it is a call for a case, and Christmas is 
not far distant. 

"Nurse Cameron?" inquires Dr. Mar- 
tyn. 

"Yes, Dr. Martyn." 

"Would you take a case — a contagious 
case — immediately, leaving here by the 
first train, due in one hour, for Raymond, 
N. H.?" 

"Well, I think so. Yes, Dr. Mar- 
tyn. What is the case? Diphtheria?" 

But the sound on the wire drowns the 
word and Dr. Martyn hangs up the re- 
ceiver, thinking the conversation finished 
and clearly understood. 

Miss Cameron calls for the "Nurses' 
Bureau" at the office of Dr. Martyn 
again and again, but in vain, as the Cen- 
tral girl at the telephone office informs 
her of trouble on the line. She finally 
walks up the stairs to her comfortable 
quarter.? and hurriedly repacks her bag. 

Miss Cameron wonderingly expresses 
her thoughts aloud. "Dr. Martyn forgot 
to mention who my patient's to be — 
name or sex. I know nothing about 
the case or place. And still continuing her 
soliloquy, she dons her traveling suit. 
TTcaring the street car in the distance she 
takes her traveling bag and rushes hur- 



riedly to the street corner to catch the car 
which goes by the railway station. 

It is a malignant type of diphtheria, 
Dr. Ross, the physician in charge of the 
case, is telling Miss Cameron, with 
which the family are afflicted. 

"Family?" questions the nurse. 

"Yes, Miss Cameron; a family of 
three — father and mother, and child of 
two years. People extremely poor, and 
all needs and requirements will be fur- 
nished by the town." 

A drive of seven miles brings them to 
a small three-roomed camp. As Miss 
Cameron enters the living room a pa- 
thetic scene meets her gaze. Amid filth 
and squalor lie father and mother, chok- 
ing and panting with every heartbeat, 
with the little child between them in a 
broken iron bedstead, which is tied up 
with rope to support it. Nurse Cameron 
rapidly prepares for work, and, under the 
circumstances, it looks discouraging, for 
where to commence first is hard to de- 
termine. 

"Had I known, would I have come?" 
The nurse is asking herself, but cheer- 
fully cares for her patients. Meantime 
a man approaches and raps loudly at the 
door. Nurse Cameron tells him the many 
needs of the people, which the man 
makes a memorandum of, and promises 
will be furnished at once. Three com- 
fortable cots, screens, wash basins, tow- 
els, bedding etc. Groceries seem to come 
by magic. 

Three weeks creep slowly by, and none, 
save the doctor and health officer, have 
been near the place, for another nurse 
or assistant could not be secured to aid 



34 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Nurse Cameron. Finally, the work of 
cleansing for the dayis over, as the pa- 
tients are now convalescing nicely. 

"Miss Cameron, ain't yer goin' ter rest 
yerself ? Yer too good a lookin' woman 
to be doin* the loiks o' this. You'll find 
the loft fer to rest a likely place, and I'll 
mind the fire meself," speaks Mr. 
O'Brouse, in a very authoritative manner, 
which, Nurse Cameron finds out a little 
later, is due to the fact of too fre- 
quent use of alcohol prescribed by 
the doctor as a gargle. Miss Cameron 
quietly turns out a part of the alcohol, 
substituting water, and resumes her bed- 
making. The room has gained a hospi- 
tal effect with systematic overhauling, 
and her patients gradually feel that they 
are being cared for better than they 
could have dreamed. 

"Sure, and it's next ter heven, it be. 
The saints and all be thanked for the 
goodness of ye, and your care of us. 
Me throat's well; but, faith, and the 
doctor sez you'll ma'be have to spend 
Christmas with us. Do ye think ye'll be 
lonesome with the loiks of us?" asks 
Mrs. O'Brouse, as Miss Cameron dresses 
the baby, whom the doctor has given 
permission to sit up for the first time. 



Nurse Cameron does not reply, but a 
shadow steals over her face. "Why, yes, 
Mrs. O'Brouse, it is a disappointment, 
for it is a long time since I spent a 
Christmas with the dear ones at home, 
but let us make the best of it, and be as 
merry and happy as circumstances will 
allow." 

Christmas morning comes. Nurse 
Cameron has procured from the old man 
who brings the daily supplies a small fir 
tree and candles. Unknown friends send 
home-made candies and goodies. A 
hamper of good things from Dr. Ross 
arrive, and very much needed clothing 
from a church society. Other presents 
pour in mysteriously, and, indeed, it is a 
glad Christmas for the convalescents. 

Nurse Cameron's letters bring her 
many happy moments, and she feels re- 
paid for her care and labor in the happy 
looks of her patients. 

One week later the placard is removed 
from the door, the fumigation completed 
by the health officer, and Miss Cameron 
prepares to leave. As she bids farewell to 
the O'Brouses, with kind wishes for a 
bright New Year, somehow Christmas 
has been a glad one, for a duty has been 
performed. 



St. Lou 

On December 2 the graduate nurses of the 
St. Louis Mullanphy (Hospital) Training 
School held a meeting in the class room of 
the hospital, the purpose of which was to 
organize an Alumnae Assiciation. 

The meeting, which was well attended, was 
called to order about 3 -.30 p. m. by the super- 
intendent of the hospital, Sister Gabriella. 
who explained to those present the object and 
advantages of the association. Mrs. Virginia 
Ring was appointed temporary president, and 
presided at the meeting. Miss Mattie F. 
Howard was appointed temporary secretary. 

A committee, consisting of Miss Mary 
Rider, Miss Elizabeth M. Lanigan, Miss 



is, Mo. 

Catherine Collins and Miss Sophia Grim, was 
appointed to draw up the by-laws and submit 
them at the next meeting, at which time they 
will be passed upon. At the next meeting, 
which will be held the first week in January, 
the election of officers for the year will take 
place. 

All expressed themselves delighted and well 
pleased with the result of the meeting. 

To our ever thoughtful, interested and kind 
superintendent-in-chief, Sister Gabriella, we 
tender our sincere thanks and appreciation for 
her kind assistance and aid, to which we owe 
the establishment of our Alumnae Association. 
Mattif. F. Howard, Secretary. 



department of ^rm^ Jftumng 



DITA H. KINNEY 
Superintendent Army Nurse Ccvps 



THE discharges since our last army 
notes are: Margaret V. Soule, 
from Fort Bayard; Bertha M. Krotzer, 
from Division Hospital, Manila, P. I.; 
Mary J. Kennedy, from San Francisco ; 
Florence A, Houghland, Mrs, Christi- 
ana M. Bauer, Mathilda C. Andresen 
and Nannie M. Washington, also from 
the General Hqspital, San Francisco. 

Miss Soule was married to a private 
of the Hospital Corps, U. S. Army, in 
Silver City, while on leave of absence. 
Chief Nurse Christiana M. Bauer was 
discharged at her own request, after 
many years of faithful and valuable ser- 
vice to the Army Nurse Corps. Her 
loss is noted with deep regret, and the 
good wishes of the superintendent and 
members of the corps follow her where- 
ever duty or pleasure may call her. 

The appointments have been : Eliza- 
beth Kurzdorfer, graduate of Deacon- 
ess Hospital Training School, Evans- 
ville, Ind., 1899; Elsie Marion McKallip, 
graduate of the South Side Hospital, 
Pittsburg, Pa., 1906, and Mary D. 
Macdonald, an "old" and valued army 
nurse, has been re-appointed. All of 
ihe above named nurses have been as- 
signed to duty at the General Hospital, 
Presidio of San Francisco. Another 
"old" army nurse, Julia Woods (re- 
appointed to the service a year ago), 
has successfully passed the examination 
for promotion to chief nurse, and will 
sail to the Philippines for such an as- 
signment in that division. Miss Woods 
has lately been on duty at Fort Bayard. 



Sigrid C. Johnson and Mrs. Mary B. 
Hall have been transferred from the 
General Hospital, Presidio, of San 
Francisco, to Fort Bayard for duty ; 
Nurse Mary H. Hallock, transferred 
from Fort Bayard to San Francisco. 
Miss Hallock with Miss Mary Agnes 
Sweeney sailed to the Philippines for 
duty on December 5. Miss Grace E. 
Leonard, recently arrived from San 
Francisco, has been transferred from 
the General Hospital, that city, to Fort 
Bayard. Martha R. AUwein, who ar- 
rived on the last transport from the 
Philippines, has been assigned to duty 
to the Presidio. Helen M. Pickel, hav- 
ing finished her tour of duty at Fort 
Bayard, has been transferred to the 
Presidio of San Francisco. Miss Pickel 
will be replaced at Fort Bayard by 
Valeria Rittenhouse, recently on duty 
in San Francisco. Josephine Hensel, 
recently arrived in the Philippines, has 
been assigned to duty at Fort William 
McKinley. Clara C. Doersch, also re- 
cently arrived there, assigned to duty at 
the Division Hospital. Ethel Florence 
Cook, transferred from Camp Jossman 
to Division Hospital; Clara Maria Sel- 
over, from the Division Hospital to 
Zamboanga; Clara L. Postlewait, from 
Zamboanga to Camp Keithley; Agnes 
Astbury and Sarah M. Hepburn, from 
Camp Keithley to Division Hospital ; 
Josephine Riedy, from Division Hos- 
pital to Camp Gregg, Pangasinan, for 
temporary duty, on completion of 
which she will return to her proper 



36 



THE TRAINED NURSE AND HOSPITAL REVIEW 



station ; Marie A. Riordan, recently ar- 
rived in the Philippines, has been as- 
signed to duty at the Division Hospital. 

Miss Sarah Burtiss Myer, another 
Fort Bayard nurse, has requested dis- 
charge at the expiration of her term, 
and will take post-graduate work in the 
New York Eye and Ear Infirmary, to 
be near her mother, who is in delicate 
health. 

Felicitations are in order for Mr. and 
Mrs. Arendt, on the biith of a son. Mrs. 
Arendt was Miss Helen Gottschalk, 
late chief nurse at the General Hos- 
pital, Presidio of San Francisco, and 
a graduate of Mount Sinai, New York 
City. 

The news comes from Mrs. VVillessie 
Perkin Garrett that she and her hus- 
band are settled in a little home near 
Thermopolis, Wyo. While they are 
quite a distance from any railroad, they 
seem to have no lack. There are some 
famous hot springs quite near, and a rail- 
road is promised very soon. They are liv- 
ing in a little two-room house and are 
apparently very happy. Mr. Garrett and 
his wife were childhood friends. 

Nurse Elizabeth F. Chambers, after 
leaving the service, accepted a position 
for a few months in Bishop Brent's 
new hospital in Manila. Her time there 
was short, as she had promised to take 
a private case. At the completion of 
her private duty she expects to return 
to Bishop Brent, though when heard 
from she had not decided whether she 
would stay there permanently or not. 

The City and County Hospital, of 
San Francisco, having been given over 
to the plague victims, its other patients 
and nurses in training had no place to 
go. Two of the wards ("B" and "J") at 
the General Hospital, were offered the 
City of San Francisco for some of their 



patients, and since September there 
have been eight under-graduate nurses 
on duty in the latter hospital, with two 
army nurses as head nurses of the 
wards, namely. Misses James and Mc- 
Van. About 80 or 100 of the city's pa- 
tients are accommodated in these 
wards. These extra nurses have been 
assigned to quarters in the adm'nistra- 
tion building, where they have foui very 
pleasant rooms. They have then meals 
in the Nurses' Quarters, in the army 
nurses' mess. This is a very agreeable 
arrangement, but crowds the nurse 
corps quarters very much. After the 
extermination of the plague in the City 
of San Francisco, the old City and 
County Hospital will be burned. I am 
sure no one will disagree with me when 
I say such action is taken none too 
soon. 

A nurse recently assigned to Fort 
Bayard writes: 'T was hurt at this Fort 
Bayard deal at first, but I find I am Hk- 
ing it. This is a beautiful country. We 
have been out on horseback sometimes 
fourteen to sixteen miles a day — way off 
into canyons, over hills and across long 
stretches of level road that the ponies 
love. And there is an opal ledge to be 
explored, and Indian graves and In- 
dian picture rocks, and, oh, lots of 
other things, and I am happy and en- 
joying it." 

The chief nurse at the Division Hos- 
pital writes: "We have had a concrete 
walk put in from the street to the 
nurses' quarters, and the driveway has 
been gravelled. Our groceries are now 
delivered by a real delivery wagon in- 
stead of a "carametto," as heretofore. 
These things, and some others which I 
cannot just now remember, have con- 
tributed very considerably to the joy 
of our housekeeping." 



Clittoriallp ^peafeing 



Why Opinions Differ 

In this issue we present an article en- 
titled, "Another View of Hospital Work 
Among the Poor," in which the author 
disagrees with the opinions so ably ex- 
pressed by Miss Jane Addams, of Hull 
House, Chicago, 111., in an address before 
the American Hospital Association, and 
which was republished in our Decem- 
ber number. 

Here we have an instance of two 
women, both of exceptional ability and 
experience, holding opinions which seem 
in direct contradiction to each other. 

But, as we have so often pointed out. 
■'the spectator sees most of the game." 
So, from our editorial perspective, we 
affirm that these women are both right, 
each in her individual experience, but 
both wrong if they hold that this ex- 
perience is in either case usual. 

To summarize both sides. Miss Ad- 
dams, for many years the successful 
head of one of the greatest philanthrop- 
ic institutions in America, believes that 
"hospitalization" is too common. That 
is, that humanity of treatment is lost 
sight of, in the attempt to obtain perfec- 
tion of order and discipline. That the 
patient ceases to be regarded as a man 
or a woman, but becomes merely a case. 
It was evident that under this mild ar- 
raignment, calmly and moderately put. 
Miss Addams concealed a great depth of 
feeling and held herself under great re- 
straint, and from under her polished and 
polite expression there gleamed a burn- 
ing sarcasm and an irony like the gleam 
of steel beneath the baldric of a knight. 
On the other hand, the writer of the 



article in this number, a successful nurse 
and superintendent of both training 
school and hospital, contends that 80 per 
cent, of patients like the hospital, and 
would gladly acknowledge it. Eighteen 
per cent would be chronic kickers to 
whom nothing was ever satisfactory, and 
that less than 2 per cent have any real 
cause for complaint. 

How did these two capable minds ap- 
proach their subject? Miss Addams 
sees it first from the patient's point of 
view, is impressed that her people hate 
the hospital, and is on the lookout for 
the reason. In searching for this she 
saw every neglect and omission, every 
stupid rule, every act of carelessness or 
callousness. As her people were the 
very poor, and the hospitals the great 
city institutions of a cosmopolitan cen- 
tre like Chicago, she naturally saw an 
unusual number of those occurrences 
which make the thoughtful at times 
despair of hunfenity. 

The other writer has been in the dif- 
ferent atmosphere of less cosmopolitan 
cities. She began with the other side 
of the question, and it would not be 
unjust to her to suppose a slight unin- 
tentional bias from training. But fur- 
thermore, her own good management of 
the institutions intrusted to her charge 
naturally very materially lessened her 
opportunities to witness the class of in- 
cidents of which Miss Addams com- 
plains. We believe we see both sides of 
the question, and have no bias toward 
either except that inculcated by wide op- 
portunities for observation extending 
over a period of years. We are inclined 



38 



THE TRAINED NURSE AND HOSPITAL REVIEW 



to moderate both views, while inclining 
slightly to the side of Miss Addams. 

Take the world at large, why is it 
that the rich and poor, the intelligent 
and the ignorant usually dislike the hos- 
pital and prefer home in case of sick- 
ness in spite of the special facilities of- 
fered in the former ? It is because there 
is so often a real neglect of the human, 
personal element of the patient. Nurses 
may not always notice this because of 
habit, training and the explanation that 
this and that is necessary for order and 
discipline. 

But order and discipline, while neces- 
sary, may be carried too far. There 
comes to mind the remark of one of 
the most successful and popular 
nurses, that for the rest of her life she 
would be haunted by the recollection of 
some of the things to which she had 
been forced to, subject the sick for the 
sake of ward routine while in training. 
At the time this troubled her but little — 
it was the custom, and was plausibly ex- 
plained and justified. But in the light 
of later and more extended experience, 
and with the accumulation of knowledge, 
these scenes rise before 'her mind's eye 
with horror. 

It must be understood that we are not 
condemning the ward discipline which 
mak^s for the greatest good of the 
greatest number, but such brutalities as 
waking a patient from a sound sleep to 
wash his face, take a temperature, or to 
prepare for the doctor's visit. Who is 
the doctor that sick humanity should be 
outraged for him ? We also unhesitating- 
ly condemn waking a patient at an ab- 
surdly early hour, when vitality is at its 
lowest, because ward routine must begin 
at this time. \\'e have seen this practiced 
not only upon ward, but private patients. 
We believe the fright and nervous ex- 



citement, the chafing and open rebellion 
against obviously stupid rules of rou- 
tine, is an important factor to retard 
progress with the ordinary patient, and 
has prolonged the illness of many. 

It is also a short-sighted policy from 
a business' point of view. If hospitals 
looked after the comfort of their patients 
a little more, and also took some care 
of the mental wellbeing, there would 
be more pay patients, and we all know 
what this would mean to the hospital 
situation in the long run. 

+ 
Old Advice for the New Year 

"There is no new thing under the 
sun." Even the New Year itself will 
soon be forgotten under the stress of the 
rush and turmoil of modern life. So we 
need no new advice, we make no new 
resolutions, but rather we turn back the 
pages of the year that is past, seeking 
the advice which we have failed to carry 
out, together with the resolutions we 
have neglected to make good. 

In an address made to a graduating 
class of nurses Miss Harriet Fulmer 
speaks of the modern trained nurse as 
one of the greatest social factors of the 
time. A social factor because she up- 
lifts and betters people and conditions 
wherever you find her, and as a social 
factor her capacity is absolutely with- 
out limitations. Such a statement is in 
itself an inspiration, and in one short 
sentence Miss Fulmer supplies the key 
which can solve the hardest nursing 
problem, whether considered individually 
or collectively. 

"Go where you are most needed." 
The moment this advice is carried out 
the spirit of commercialism, the tra:les 
union classification of cases according to 
price, will vanish. In the words of Miss 



THE TRAINED NURSE AND HOSPITAL REVIEW 



39 



Fulmer, we say to each and every nurse 
on the threshold of a New Year, "Set 
the pace!" When a call comes, go, be- 
cause you are needed, and you will be 
sure then to find "joy in your work." 

FOREGROUNDS AND BACKGROUNDS. 

On another page of the old year's 
records we notice the name of Dr. Rich- 
ard C. Cabot underlined again and 
again. Everything that Dr. Cabot says 
to the nurse is helpful, but we doubt if 
anything has ever been spoken or writ- 
ten which is more helpful to the nurse, 
or which has awakened her sympathy 
and given her a better insight into the 
heart of things than his address, "Fore- 
grounds and Backgrounds in Work for 
the Sick." He mentions a group of ex- 
amples of blindness to foregrounds "due 
to the habit of looking off into the dis- 
tance over the head (as it were) of the 
fact before us, and of blindness to back- 
grounds in which the sufferer can see 
nothing except the facts in front of his 
nose. In the simplest language he shows 
us what unconscious cruelty we are often 
guilty of, through these two forms of 
blindness. He shows that the nurse's 
duty to the doctor may be discharged by 
faithfully carrying out his orders, but 
her duty to her patient covers a field of 
endeavor far wider than this. Finally 
Dr. Cabot says: "We are dreadfully 
prone to forget that all eternity is made 
up of half hours as transient as this, as 
simple, unimpressive and insignificant as 
this. Nothing divine, nothing heroic, 
about this mean commonplace present. 
If the occasion were imposing and re- 
.sounding we should rise to it nobly, but 
we notice nothing very important just 
here in this dingy laboratory or in that 
dreary corridor. We are almost indig- 
nant if any one tries to open our eyes. 



How can this piece of cheap transient 
drudgery be linked to anything noble or 
significant ? * * * Qne of the great- 
est illusions is, that the present hour is 
not the critical decisive hour — God give 
me insight into to-day !" 

THE HUMAN QUALITY IN NURSING. 

On yet another page of last year's 
records we notice the above heading, 
which reminds us that nurses, perhaps 
more than any other body of women, are 
constantly criticised for being "narrow," 
and, therefore, uninteresting companions 
outside of their own particular little 
circle of friends. It is the easiest thing 
in the world to slip into a rut. Only by 
taking special pains to prevent it can we 
escape it. Much of the success of the 
private duty nurse depends upon her be- 
ing an agreeable companion to the pa- 
tient after the danger point of illness is 
past, so we venture to repeat this piece 
of advice from an unknown writer: 
"Break away from the harness and the 
ruts often enough to keep the world of 
other people in view. Hear a good 
speaker once in a while. Read a good 
book often. Keep up with the times by 
reading something fresh in current liter- 
ature." The need of physical rest and 
relaxation is usually well understood by 
the nurse, but there is sometimes a ten- 
dency to overlook the fact that it is 
equally important to get mental relaxa- 
tion and change of atmosphere. There 
would be fewer nurses with impaired 
health and shattered nerves if they 
could be persuaded to use for their own 
benefit a fraction of the care and fore- 
sight which they bestow on their pa- 
tients. And this, too, comes from forget- 
ting to "break away from the harness 
and the ruts often enough to keep the 
world of other people in view." 



40 



THE TRAINED NURSE AND HOSPITAL REVIEW 



A Correction 

In the August number of The Johns 
Hopkins Nurses' Alumnae Magazine, in 
an editorial comment, "The Ownership 
of the Journal," we find the following: 
"As we learn from the report of our 
delegates to the meeting, every one 
seems to be agreed that the Associated 
Alumnae should own the Journal out- 
right — the reasons are stated very clear- 
ly in our delegates' report." 

Turning to the delegates' report to 
learn the reason, we found the follow- 
ing: "If the Journal * * * was 
owned by the association, it was felt 
that it would then aflFord to pay con- 
tributors for articles, and so obtain a 
better class of material than some of 
that appearing lately in its pages, and 
so raise the standard and interest in the 
magazine." 



Finding the above a very logical ar- 
gument, we quoted it in an editorial in 
our October number. Unfortunately, 
through proof-reader's error the word 
"some" was omitted in our quotation. This 
is a matter of much regret to us, and it 
should have been corrected earlier had 
our attention been called to it. With 
the calling attention to this omission our 
concern in the matter ceases. But we 
trust we may be pardoned if we say 
that we consider the criticisms which 
have been made of the delegates' report, 
and which appear in our Letter box this 
issue, most unjust. We agree with the edi- 
torial in the Johns Hopkins Magazine, 
that the reasons are stated very clearly, 
and we think that only a great stretch of 
imagination could place a different con- 
struction on the report from that in- 
tended by the delegates. 



Hennepin Co. Nurses' Association. 



The Hennepin County Nurses' Association, 
Minneapolis, had an opportunity to hear some 
interesting facts regarding the Philippine hos- 
pitals at the monthly meeting held November 
14 in the afternoon at the home of Dr. M. A. 
Mead. Miss Edith Rommel, president, pre- 
sided and introduced Miss Estelle Hine, a 
member of the association, who has been in 
Manila for two years as an army nurse. Miss 
Hine read from the letters she wrote to her 
mother. She was sent with one of the United 
States transports, and was in Manila when 
there were but tents and cheap shacks to 
shelter the sick and wounded. Her experi- 
ences among the sick soldiers proved the 
unsanitary condition which the army nurses 
had to cope with in their efforts to bring 
comfort and relief to the sick. Her first cases 
were taken care of in tents, with the ground 
so swamped by heavy rains thul high boxes 



were used to avoid the water, which in places 
was several feet deep. Miss Hine interspe-sed 
her talk with photographs showing the impro- 
vised hospitals shjrtly after tne war, and the 
hospitals which have been built within the last 
year. The latter are examples of modern con- 
veniences and sanitation. 



The Hennepin County Graduate Nurses' 
Association met Wednesday, November 22, at 
the residence of Dr. Marian A. Mead. About 
forty of the nurses were present and listened 
to an entertaining and instructive travel talk 
by Dr. F. A. Dunsmoor. Dr. Dunsmoor 
spoke of his last European trip, taking his 
audience on board ship in New York harbor 
and telling of his travels from one European 
city to another. After the talk coffee was 
served in the Dutch kitchen. 



3n tl)e Jtursmg Woxlb 

ARTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATURE OR NOT, ARE CONTRIBUTED, AND DO 
NOT NECESSARILY REPRESENT THE IDEAS OR POLICY OF THIS MAGAZINE. 



The Visiting Nurse. 

The women's clubs and lodges of Fort 
Dodge, Iowa, have organized a Visiting Nurse 
Association. One nurse is employed. She 
commenced her duties September i, and in 
the first two months made 127 calls and col- 
lected $43 in fees. 



Gifts to the amount of nearly $900 were 
turned in at the stations for the benefit of 
the District Nurses' Association of Grand 
Rapids, Mich. This is within a very few 
hundred dollars of the sum required to carry 
on the work of the association for the com- 
ing year. Besides this amount there are a 
number of schools to be heard from, so that 
the amount will very nearly approach the 
required sum for the year's expenses. 



Circulars calling attention to the newly or- 
ganized Visiting Nurse Association of Mil- 
waukee were distributed recently in all Mil- 
waukee churches, that knowledge of the asso- 
ciation's aim and work might be brought to 
the attention of those who are interested in 
this admirable effort to relieve the needs of 
the sick poor. 

One visiting nurse, now supported by a 
private citizen, has during the past year made 
1964 visits and has cared for 230 patients. 
Iler work has demonstrated that there is need 
for greater effort in this field in Milwaukee, 
and has led to the formation of the present 
organization. 



A meeting of the Visiting Nurses Associa- 
tion of Richmond, Va., was held October 22 
at the Nurses' Settlement at 12 o'clock. This 
is the first meeting of the association since 
last June, and important business was trans- 
acted. 

The most important feature of the meeting 
was the reading of a letter from Dr. Levy, 
of the Health Department, suggesting that 



the nurses of the association divide the city 
in five sections instead of four, as hereto- 
fore, and that the Health Department pay an 
extra nurse to co-operate with those already 
at work in the city. It was decided to accept 
Dr. Levy's proposition. In connection with 
the work of the nurses there will be five dis- 
pensaries, each under the supervision of one 
of the nurses, which will be open probably 
three times a week for the purpose of giving 
eggs, milk and other necessaries for tuber- 
culosis patients under the care of the city. 



A meeting of the Visiting Nurse Associa- 
tion of Newark, N. J., was held December 5 
in the Free Public Library, when Halsey T. 
Tichenor, the treasurer, reported that there 
is a balance of only $20. Since the number 
of patients is greater now than ever before, 
and food prices are increasing, it would take 
strenuous efforts for the next month to keep 
up the work, he said. Miss Nora Holman's 
report as head nurse showed that 578 visits 
had been made within the last month, 65 new 
patients had been cared for, 50 were dis- 
charged well and there are now 122 in need 
of care. 



The Medford (Mass.) Visiting Nurse As- 
sociation, which has for some time been con- 
sidering the advisability of becoming an in- 
corporated body, has finally taken this im- 
portant step, and is now a duly chartered 
corporation, chartered under the laws of 
Massachusetts, the charter having been ob- 
tained by J. Mott Hallowell. 

This action is an important one in the his- 
tory of the association, and ought to add to 
its usefulness and its permanency. Among 
other results, it will free the members from 
any form of individual liability. It also makes 
a permanent and responsible body to which 
charitable bequests and trusts can be left for 
the purpose of carrying on the work of the 
association. 



42 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Graduate Nurses' Association of Pennsyl- 
vania. 
The fifth annual meeting of the Graduate 
Nurses' Association of the State of Pennsyl- 
vania, was held at Hotel Schenley, Pittsburg, 
Pa., October i6, 17, 18, 1907. 

The president. Miss Roberta West, in the 
chair. 

The opening prayer was offered by Rev. J. 
F. McCrorey. Addresses of welcome were 
given by Dr. Otto Gaub and Dr. C. C. Rine- 
hart, to which responses were made by Miss 
Helen F, Greaney and Miss Bernice Congor. 
Dr. Charles White, medical director of Pitts- 
burg Sanitarium, spoke on the "Nurse's Re- 
lation to Tuberculosis," and upon request gave 
a lecture Thursday afternoon on the "Preven- 
tion and Cure of Tuberculosis." 

Prof. Hammerschlag, director Carnegie 
Technical Schools, in addressing the meeting 
on the "Educational Opportunities for 
Nurses," referred to the institution just opened 
in Pittsburg, for the practical education of 
women, and offered to add to their curricu- 
lum any course which will be of benefit to 
nurses. 

The president made a short report of the 
year's work, and gave an outline of the plans 
and aims of the association. 
Secretary's report approved as read. 
Chairman of the Membership Committee re- 
ported thirty-three (33) applications. Ap- 
proved. 

Treasurer reported receipts up to Septem- 
ber 30, T907, $1,717.60; disbursements, $1,- 
45377, leaving a balance on hand of $263.83. - 

Delinquent members will be sent one more 
notice, and are urged to pay all back dues 
promptly. 

Report of the Legislative Committee and 
introduction of Mr. NicoUs, who had pre- 
pared a draft of a new bill, which was taken 
up section by section, and the reasons for the 
various changes explained. On motion, a copy 
of the bill as amended will be sent to each 
member. 

The proposed amendments to the by-laws 
were taken up and accepted as read, the most 
important one being that applicants for mem- 
bership must be members of their alumnae as- 
sociations. 

Before proceeding to vote the following 
nominations from the floor were added to the 
ballot 



For first vice-president. Miss Elizabeth 
Reid; for second vice-president. Miss Lydia 
A. Giberson; for fourth director, Miss Maude 
Miller. 

The Chair appointed as tellers, Mrs. Eden, 
Miss Nellie O'Sullivan and Miss Schofield. 
While waiting for report of tellers. Miss 
Moultre's paper on "Almshouse Nursing" was 
read by Miss Ida Gailey. 

It was decided that the association publish 
a journal, to be issued quarterly. Miss West 
was appointed chairman, to choose her own 
associates for this work. Subscriptions to be 
one dollar annually, or twenty-five cents a 
copy, which should be sent for the present to 
Miss West. 

How to provide nursing for the families of 
moderate means was discussed, and on motion 
a central committee is to be appointed to or- 
ganize and to secure for Pennsylvania a sys- 
tematic and permanent association for visiting 
nursing. 

Chancellor McCormick, of the Western Uni- 
versity of Pennsylvania, spoke of Progressive 
Education and conferred upon "Nursing" 
the title of "Profession" and giving it third 
place on the lists. 

Miss Kumm read Mrs. Gretter's paper on 
the Hospital Economics Course at Columbia 
University, and Miss Hanlin and Miss Held- 
man read papers on "Settlement Work." 

In the way of entertainment a tea and re- 
ception were given at Allegheny General Hos- 
pital on Thursday afternoon, and on Thurs- 
day evening a banquet at Hotel Schenley, to 
which one hundred and eighteen (118) mem- 
bers sat down, were both thoroughly enjoyed. 
During the course of the banquet a cameo pin 
was presented to Mrs. Lewis, the retiring sec- 
retary, and a gold bracelet to Miss Cummis- 
key, the retiring chairman of the Member- 
ship CommiUee, for their faithful and efficient 
work. 

Visits to Mercy and Columbia Hospitals, the 
Physicians' Supply Company and the Carnegie 
Margaret Morrison School proved interesting 
and enjoyable, and it is to be regretted that 
lack of time prevented acceptance of many 
other invitations. 

The following officers were elected to serve 
for the coming year : 

President, Miss Roberta West; first vice- 
president. Miss Elizabeth Reid : second vice- 
president. Miss Lydia A. Giberson; secretary. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



43 



Miss Annie C. Nodwill; treasurer, Mr. Will- 
iam R. McNaughton; first director, Miss Mary 
J. Weir; second director, Miss Caroline I. 
Milne; third director. Miss Nellie A. Cummis- 
key; fourth director, Miss Ida F. Giles. 

The next meeting of the association is to 
be held at AUentown, Pa. 

Nellie M. Casey, Assistant Secretary. 
+ 
Kentucky State Association of Nurses. 
On October 29, 30 and 31 occurred the first 
annual meeting of the Kentucky State Asso- 
ciation of Graduate Nurses. 

It was held at the City of Lexington. 
The Medical Society of this city donated 
the use of their room in the Public Library for 
the deliberations of the assembly. 

There were five sessions. The programme 
of the opening session was as follows : 

Call to order Miss Gillette, President 

Invocation. .Prof. B. C. Hagerman, Lexington 
Address of Welcome, 

Dr. F. H. Clarke, Lexington 

Response Miss Fisher, Owensboro 

Address, "State Registration," 

Dr. G. P. Sprague, Lexington 

Address Dr. J. A. Stucky, Lexington 

During the sessions the members were in- 
terested, inspired and instructed by the reports 
of the officers. 

Report of Miss Gillette, delegate to the Na- 
tional Convention of the Associated Alumnae, 
Richmond, Va., and of the International Con- 
ference, Paris, France. 

Report by Miss Laura Wilson, delegate to 
the State Federation of Women's Clubs, 
Shelbyville, Ky. 

Address by Miss Sly upon "The Hospital 

Economics Course at Teachers' College, N. Y." 

Paper, "Value of the Trained Nurse in the 

Public School," by Miss Harriet Butler, of the 

W. C. T. U. Settlement, Hindman, Ky. 

And the reading and explanation of the bill 
for State registration by Miss Sly. 
The election of officers resulted as follows : 
President, Miss Gillette, Louisville; first 
vice-president. Miss Shaver, Lexington ; sec- 
ond vice-president. Miss Lustnauer, Louisville; 
recording secretary. Miss Porter, Louisville ; 
corresponding secretary, Miss Rece, Louisville; 
treasurer, Miss Tuley, Louisville; cliairmon 
of standing committees — Ways and Means, 
Miss Dear, Louisville; Credentials, Miss Beck- 
man, Louisville; Nominating, Miss McCann, 



Lexington; Arrangements, Miss Francis, 
Louisville; Publication and Press, Miss Wil- 
son, Louisville. 

The meeting adjourned to meet next year 
in Louisville. 

The social features were: 

A reception, tendered by the Board of Man- 
agers and Superintendent of the Good Sa- 
maritan Hospital, with inspection of the new 
building. 

Reception, with collation in sympathy, with 
the Pure Food Law, by the Alumnae of the 
Good Samaritan Hospital, and an automobile 
ride to the famous stock farm of J. B. Haggin. 

The visiting nurses were delightfully enter- 
tained in the homes of the directors of the 
Good Samaritan Hospital. 

The press was most generous, publishing 
daily full accounts of the proceedings. 

The association now has 129 members. 

Respectfully submitted, 

Laura A. Wilson, 
Chairman Publication and Press Com. 



On November 30 a delegation from the 
Kentucky State Association of Graduate 
Nurses, consisting of Miss Gillette, Miss Rece 
and Miss Wilson, attended a meeting of the 
Educational and Legislative Committees of 
the Louisville clubs, which are members of 
the State Federation. 

The purpose of the meeting was to discuss 
school suffrage for the women of Louisville. 

It was voted that the delegates present 
should report to their respective clubs, and 
urge the necessity of working for the bill to 
be presented to the next Legislature. 

Said bill shall permit women to vote for 
school officials, to serve upon school boards, 
and shall also provide for a separate election 
for this purpose, thus divorcing the school 
question from politics. 

The Jefferson County Graduate Nurses' 
Club, at the regular meeting of December 2, 
went on record as approving this action of 
the other club women of Kentucky. 

Both associations realize that the first step 
to make superior nurses is to give the little 
girls a good education. 

Miss Rece, our special representative to the 
Legislature, will go to Frankfort in January 
to look after the presentation of the bill for 
State registration for nurses. 

Respectfully submitted, Laura A. Wilson. 



44 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Graduate Nursee' Association of West Va. 

The second annual meeting of the West 
Virginia State Graduate Nurses' Association 
was held in Wheeling, W. Va., November li, 
12 and 13. There were fifty members present. 
This is a young society, but in interest and 
enthusiasm it compares favorably with older 
societies. Total membership, 187. 

West Virginia nurses have at last achieved 
registration, and the meeting was largely one 
of congratulation and thanksgiving. 

The president's address was a review of the 
work of the past year. Emphasis was laid 
upon the added responsibility resting upon 
each registered nurse. Six of the most emi- 
nent of Wheeling physicians visited the con- 
vention and made short addresses, as did also 
several clergymen. These visits and the kind- 
ly words of encouragement and advice were 
keenly appreciated by the convention. 

The $50 promised at Richmond by our dele- 
gate for the endowment of the Chair of Hos- 
pital Economics was approved. 

There was much earnest discussion of the 
nurses' salaries. The custom of many train- 
ing schools of sending out pupil nurses to 
case after case, was warmly discussed and 
heartily condemned. An interesting paper on 
"The Realization of Our Ideals," was read 
by Miss A. C. McKay, superintendent of the 
training school of the Sheltering Arms Hos- 
pital, Hansford. Also one on "Practical 
Points in Private Nursing," by Miss Millette, 
superintendent of the training school, Reyn- 
olds Memorial Hospital, Glendale. 

Much credit is due to the Committee of 
Wheeling Nurses, Miss Dessell, Miss Pierce 
and Miss McMahon, for the delightful enter- 
tainment provided for the association. Elach 
of the hospitals, City, North Wheeling and 
Haskins, provided bountifully for their good 
cheer, and a banquet was given at the McLure 
House to the visitors, which was beautifully 
appointed in every way. Wheeling hospital- 
ity and good will will long be remembered 
by all the visitors. 

• The next place of meeting will be Fair- 
mont, W. Va. 

The following officers were elected : 

President, Mrs. Lounsbery, Charleston; first 
vice-president, Miss A. C. McKay. Hansford; 
second vice-president, Miss Naomi Simmons, 
Fayette; third vice-president, Mrs. Carpenter, 
Wheeling; fourth vice-president, Mrs. Ken- 



dall, Fairmont; fifth vice-president. Miss Mil- 
lette, Glendale; sixth vice-president, Miss Tay- 
lor, Grafton; seventh vice-president. Miss 
Gaule, Huntington; secretary, Miss Pierce, 411 
South Front street. Wheeling; treasurer, Miss 
McMahon, Wheeling. 

+ 
New York City. 

The Alumnae Association of the Roosevelt 
Hospital Training School for Nurses held a 
fair for the benefit of the fund for sick 
nurses December 5 and 6 in the administra- 
tion building of the hospital. The arrange- 
ments and decorations were very artistic and 
the fair an unqualified success, netting a large 
sum for the fund. 

-C 

The New York County Nurses' Association 
gave a tea in honor of Miss Adelaide Nutt- 
ing, director of the department of hospital 
economics in the Teachers' College, Friday 
afternoon, December 6, from 4 to 6 o'clock, 
at 525 West One Hundred and Twentieth 
street. There was a very large attendance. 



A benefit dance will be given by the Flower 
Hospital Nurses' Alumnae Association on Jan- 
uary 16, 1908, at the New York Homoeopathic 
College, East Sixty-third street and Eastern 
boulevard. The proceeds are to go toward 
endowing a bed in the hospital. Tickets $1, 
on sale by Miss Towner, 80 West Fortieth 
street. 



The Alumnae Association of the N. Y. C. 
Training School for Nurses gave a recep- 
tion in honor of the retiring superintendent 
of the school, Miss Mary S. Gilmour, at the 
Hotel Gotham, Wednesday evening, December 
18, from 9 to I o'clock. Full account in our 
next number. 



Albany, N. Y. 

Enthusiasm, which promises to make the 
project one of the greatest successes ever 
handed out to sweet charity in Albany, char- 
acterizes the efforts of Troop B, of the local 
cavalry force, now being put forth for the big 
minstrel show and vaudeville performance to 
be held at Harmanus Bleeker Hall on Mon- 
day night, December 23, under the troop's 
auspices for the benefit of the training schools 
of the Albany and the Homoeopathic hospitals. 



d 



THE TRAINED NURSE AND HOSPITAL REVIEW 



45 



Society has entered into the project with a 
determination to make it the record-breaking 
charity affair of the year, and co-operation 
toward this end is being received from all 
sides. 

Governor and Mrs. Hughes are among the 
first to secure boxes for the performance. 

The nurses of both schools, the physicians 
of the city and many others have taken tick- 
ets by lots. 

The programme to be published will be a 
handsome souvenir of the event, and will be 
sold to help swell the receipts. 



Mr. and Mrs. Peter Schermerhorn have 
left the city. 



At the meeting of the board of managers 
of the Albany Guild for the care of the 
sick, last Wednesday morning it was decided 
to call the attention of the generous people 
of our city to the great demand made on the 
Guild. 

A temporary entertainment cmomittee was 
formed which is considering how the public 
can be best entertained, and at the same time 
give to help on the Guild's good work. 

During November forty-seven physicians 
called on the Guild for nursing aid, and these 
women, who are paid by the contributions of 
the citizens of Albany, made 1,502 visits. 
There were 157 new cases, most of whom 
need the further assistance of food and cloth- 
ing. There are eleven nurses on the Guild 
staff at present. 



Miss Mary Kearney, a recent graduate of 
St. Peters' Hospital, entertained the nurses. at 
that institution not long since. The nurses 
were in costume and could scarcely be recog- 
nized. 

Those participating were : Misses Kearney, 
Spellacy, Downey, Harmon, Newman, Reddy, 
Dietcher, Murray, Fitzgibbons, Stellar, Beres- 
ford, Carr, Burke, Toohey, Dugan, Maloney 
and Burkin. 



The nurses' alumnae of the Albany Hospital 
have adopted a resolution making the last 
Wednesday of each month club day. All 
members are requested to be present on these 
occasions. 



Miss Maude Kikelham, formerly a nurse in 
the Albany Hospital, has been appointed as- 
sistant postmistress at Haines Falls, Greene 
County. 



Mrs. Jessie G. Cuyler is engaged nursing at 
the Sahler Sanitarium, Kingston, N. Y. 



Miss Sarah Murphy, of Saranac, and Miss 
Nellie Graham, of Philmont, have entered 
the Training School for Nurses at the Albany 
Hospital. 

+ 
Utica. N. Y. 

The exercises of the graduating class of 
nurses of Faxton Hospital were held at the 
hospital Saturday evening, November 2^. The 
rooms were prettily and tastefully decorated 
with palms and flowers and the founder's 
portrait, with the Red Cross flag, in recogni- 
tion of the subject of the speaker of the 
evening, the Hon. Colonel William Cary 
Sanger, 

Rath's Orchestra furnished fine music at 
intervals throughout the evening. The exer- 
cises opened with prayer by Rev. J. Winslow 
Clarke. Dr. J. H. Glass presided and intro- 
duced the speaker. 

Among other things Colonel Sanger said: 
"The work of the Red Cross Society does 
not appeal to all, for they cannot see the use 
of it in time of peace." Colonel Sanger made 
this the principal point of his address, to 
show how useful such an organization is in 
time of peace in caring for the sick in times 
of epidemic and the wounded in time of 
casualty. In Germany the society has an im- 
portant part in the campaign being made 
against tuberculosis. In Italy the society takes 
measures to prevent the spread of fever 
caused by the presence of large marshes. 
Germany has between 3,000 and 4,000 nurses 
enrolled, a larger number than any other Con- 
tinental country. 

Colonel Sanger then stated that the Red 
Cross had committed itself to the crusade 
against tuberculosis and also to the prevention 
of accidents, and urged nurses to affiliate 
w'th the society. 

Dr. James H. Glass made an address to the 
nurses, in which he referred to the opening 
of the Vedder Memorial Pavilion, and ex- 
pressed sympathy with the family in its be- 
reavement by the recent death of Abram G, 
B rower. 



46 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Diplomas were presented to the following 
graduates : Miss Harriett D. Church, of Utica ; 
Miss May Lincoln, of Hamilton ; Miss Rose 
Peterson, of Rome; Miss Adelaide Baumgard- 
ner, of St. Johnsville; Miss Alwilda Wright, 
of Canterbury Station, Can.; Miss Bertha 
Williams, of Lowville; Miss Pearl Stout, of 
Auburn, and Miss Nettie R Metzger, of 
Broadalbin. 

Mrs. Edwin Thorn, president of the board, 
congratulated the graduates and presented 
each with a case of instruments. The super- 
intendent, Miss C. M. Perry, presented each 
with a book, and one of the members of the 
surgical staff presented each with an ice bag. 

After the exercises many remained to in- 
spect the Vedder Memorial. Ice cream and 
cake were served, and all were hospitably en- 
tertained. Later a reception was held in the 
nurses' building. 

Wheeling, W. Va. 

The Haskins Alumnae Society of Wheeling, 
W. Va., held its annual meeting in the recep- 
tion rooms of the training school December 
2, 1907. 

The following officers were elected : Presi- 
dent, Mary Crump; first vice-president, Mary 
Hofman ; second vice-president, Mrs. Deegan : 
secretary, Vera Thompson; treasurer, Alice 
Fowler. 

The annual dues were paid. 

Various matters were discussed by members 
present. 

After adjournment dainty refreshments 
were served by Miss Bertha Mansfield, super- 
intendent of the training school. 

Vera Thompson, Secretary. 
+ 
Nurses' Association of Buffalo. 

The December meeting of the Buffalo 
Nurses' Association was one of the largest 
and most brilliant in its history. Officers and 
members of all the Women's clubs in the city 
were guests. Mrs. Harriet Dorr Storck, the 
president, was in the chair. 

The principal feature of the meeting was 
the paper, "The Cry of the Children," by Mrs. 
Frank H. Bliss. 

The paper is one which Mrs. Bliss read be- 
fore the Western Federation of Women's 
Clubs at its Rochester meeting, but was new 
to many Buffalo women. 

Dr. Anna Shaw, after hearing this paper, 



got up and said : "Women, what are you 
going to do about it?" 

Mrs. Bliss gave a history of child labor and 
the Juvenile courts, and told of the cruelty 
and injustice to children as the result of in- 
difference and neglect. 

She also told of the work of the penny 
luncheon fund of the City Federation. 

This is a plan by which several hundred 
little children in the public schools are given 
a warm luncheon daily. It has been very suc- 
cessful and last winter over seven thousand 
lunches were served. The association voted 
to give $20.00 to this fund, and $10.00 to the 
District Nurses' Association. 

Miss Sylveen Nye, as chairman of the pro- 
gramme committee, introduced a class of 
twelve little Italian girls from school No. 3, 
and who had been patrons of the penny 
lunches. They sang Italian songs and gave 
recitations. They were in charge of Miss 
Anna Lord, the department principal, and 
were accompanied at the piano by Miss Rosi- 
na Lepino. In compliment to the nurses the 
little signorinas wore little gray uniforms 
and white kerchiefs and caps. 

Miss Nellie Davis gave a report of the City 
Federation meeting, to which she was a dele- 
gate. 

Mrs. Richard Williams, of the Buffalo Po- 
litical Elquality Club, addressed the meeting. 
Remarks were also made by Mrs. Hyatt Smith, 
Mrs. John Cameron and Mrs. Sickles. 

At the close of the meeting ices and cakes 
were served by Mrs. Jennie T. Anderson, Miss 
Pearl Kamerer, Miss Emma Kulin, Miss Mar- 
garet Fitzpatrick and Miss Mabel Hunt. 

How can the present law, affecting the 
registration of nurses in New York State, be 
improved? 

Discussion by members and others. 

This will be the subject of the January 
meeting of the Buffalo association. As the 
Buffalo association opposed the passage of the 
present law, and has always felt that it was 
defective, some pertinent criticisms are ex- 
pected. 

New Jersey State Nurses' Association. 

The regular annual meeting of the New 
Jersey State Nurses' Association was held at 
the Free Library of East Orange, N. J., on 
the morning and afternoon of Tuesday, De- 
cember 3, 1907. 

The president in the chair. The regular 



THE TRAINED NURSE AND HOSPITAL REVIEW 



47 



routine business of officers' reports and re- 
ports of chairmen of committees and delegates 
occupied the morning session. The secretary 
reported a total membership of 250. Twenty- 
six new members having been added during 
the year. Report showed that considerable 
money had been expended without succeeding 
in getting a satisfactory new bill through the 
Legislature at its last session. 

The chairman of the old age annuity com- 
mittee reported on steps being taken by an 
insurance company of Connecticut providing 
for a small income after a certain age for 
nurses who insure with them. 

The required preliminaries in conformance 
with the constitution having been taken it 
was moved and carried a revision of the con- 
stitution be made. It was further moved that 
in doing this the date of the annual meeting 
be changed to the month of May in order to 
conform with other organizations in the State 
of New Jersey. 

The afternoon session was called to order 
at 2:30 o'clock, when an address was made 
by Mrs. H. H. Dawson, president of the State 
Federation of Women's Clubs. Mrs. Dawson 
explained in a most interesting way what the 
State Federation stood for, and how it was 
possible, for so many d'flerent organizations, 
composed of women having widely varying 
interests in life, to work together harmoni- 
ously and advantageously. The State Federa- 
tion, said Mrs. Dawson, divides its work into 
departments, i. e., the home, food, city, schools, 
legislation, organization, reciprocity, sociology, 
industrial and child labor. 

After Mrs. Dawson, the president next in- 
troduced as speaker, Mrs. Frederick Crane, 
member of the child labor committee. Mrs. 
Crane announced that there is no law in New 
Jersey prohibiting night labor for a child of 
fourteen years, and it is to secure the passage 
of such a law that her committee is now 
working. 

Three times as many accidents occur to 
children as to adults, and these are some- 
times such as to maim the ch'ld for life. 

At the close of Mrs. Crane's address the 
meeting resumed its business. Roll call 
showed but a small attendance. 

Election of officers was as follows : Presi- 
dent, Miss Ellen F. Connington, of the Eliza- 
beth General Hospital; first vice-president, 
Miss Frances Dennis, of Bellevue Hospital, 
New York; second vice-president, Mrs. Mary 



E. O'Neil, Paterson General Hospital; secre- 
tary. Miss Helen D'Arcy Stephen, Orange 
Memorial Hospital; treasurer, Mrs. Henrietta 
Reid, St. Joseph's Hospital, Paterson. 

+ 
Camp Roosevelt, New York City. 

The members of Camp Roosevelt gave a 
"tea" on the afternoon of December 4 to Mrs. 
Henry Hunt Ludlow, president of the S. A. 
W. Nurses at 19 East Twenty-sixth street. 
Notwithstanding the stormy weather of the 
day, there were present a great many of the 
members and their guests. The affair was a 
marked success, and one and all agreed on 
having had one of the most successful affairs 
yet attempted by the Camp. The next meet- 
ing of Camp Roosevelt will be held by invita- 
tion at the home of Mrs. Ammerman, 2940 
Seventh avenue, in the afternoon of Wednes- 
day, January 8, 3 to 6 o'clock. All S. A. W. 
nurses are cordially invited to be present. 

Florence M. Kelly, R. N. 

■+ 
New Haven, Conn. 

The regular monthly meeting of the Con- 
necticut Training Alumnae Association was 
held at the Nurses' Home on Howard avenue, 
December 3, 1907. There were fifteen mem- 
bers present. The meeting was called to order 
by the vice-president, Miss Stack, at 3 p. m. 

The various committees made their reports 
to the association. , 

A new committee was appointed to provide 
entertainment for the next three months, con- 
sisting of Miss A. Lanfare, Miss M. Barrett 
and Miss M. Stack. 

It was decided not to give a whist, but later 
have a lecture on China. 

After the business meeting refreshments 
were served and a social time enjoyed. 

Anna G. Ward, Sec'y. 

+ 
Married. 
Mrs. Annie Thomson, graduate of Park 
View Sanitarium, class 1906, was married Oc- 
tober 31, 1907, to Mr. H. Carpenter. Their 
future home will be in Muscogee, Indian Ter- 
ritory. 



In St. Paul's Church, Detroit, Mich., Miss 
Dora F. Riggs, class of 1905, Long Island Col- 
lege Hospital, Brooklyn, to Dr. Philip Edward 
Rossiter. Dr. and Mrs. Rossiter will make 
their future home in Pine Plains, N, Y. 



48 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Miss Qara Warburton and Dr. John Hatha- 
way Long were married November 20 at Rich- 
mond Hill, Long Island. Mrs. Long is a 
Long Island College Hospital graduate, class 
of 1905, Their home is to be in Brooklyn, 
N. Y. 

Mrs. Charles Doud announces the marriage 
of her sister, Florence M. Mastin, to Dr. 
Albert A. Joslin, Thursday, October 10, at 
Lowville, N. Y. Dr. and Mrs. Joslin will be 
at home at the Oriental, Watertown, N. Y. 



The marriage is announced of Miss Agnes 
H. Lindeberg, of x-^orwich, Conn., to Mr. 
Nathan A. Bennett, of Southwick, Mass. 



On September 10 Miss Mary A. Mulvey, 
Boston, Mass., graduate of Long Island Hos- 
pital, class of 1905, became the wife of Mr. 
William Brophy, of Dorchester, Mass. Miss 
Mulvey practised private nursing two years 
with success. The good wishes of her class- 
mates and friends follow her. 
+ 
Personal. 

The Good Cheer Qub, of San Jose, Cal., 
has a new nurse at work, Miss Hortense Staf- 
ford, who has been elected to succeed Miss 
Mabel Southwick, whose resignation was re- 
luctantly accepted by the club last month. 

Miss Stafford received her training at the 
Children's Hospital in San Francisco and has 
had other hospital experience. 



. Mrs. Annie G. Heath has resigned her posi- 
tion as nurse for the District Nurse Associa- 
tion of Ware, Mass., after four years of serv- 
ice that has been highly satisfactory. Mrs. 
Heath feels that she is in need of rest and 
recuperation, and she leaves with the best 
wishes of all that she may obtain them. 



Miss Anna B. Rohan, of Springfield, Mass., 
has accepted the position of district nurse to 
succeed Mrs. A. G. Heath, and will begin her 
duties as soon as she can arrange to do so. 



Miss Mabel King, class of 1907, Homoeo- 
pathic Hospital, Iowa City, has located at 
Des Moines, Iowa, and will practise private 
nursing. 



Miss Mary E. Reid, for many years super- 
intendent of Training School, Charleston Gen- 
eral Hospital, Charleston, W. Va., and author 
of the well known book for nurses, "Bacteri- 
ology in a Nutshell," has opened a Nurses' 
Home at 1563 Lee street, Charleston, W. Va. 

Obituary. 

Miss Verna Rogers died at Elgin, 111., June 
10, 1907, of scarlet fever, contracted while 
caring for a patient. 1 iie deceased was grad- 
uated from Sherman Hospital in June, 1906. 
The Sherman Hospital Alumnae Association, 
of which Miss Rogers was a member, had 
charge of the funeral services. The follow- 
ing resolutions were adopted by the alumnse: 

Whereas, our Heavenly Father has taken 
unto Himself our dearly beloved sister, Verna 
Rogers, 

Resolved, That the Sherman Hospital Alum- 
nae Association of Elgin, 111., has lost one 
wno was always interested in every good 
work, and whose bright, cheerful character 
shall always be missed among her sister 
nurses; and be it further 

Resolved, That we extend to her sorrow- 
ing mother our heartfelt sympathy in this 
dark hour; and be it further 

Resolved, That a copy of these resolutions 
be published in the nurses' magazines and 
placed on record in the secretary's book. 
Esther Bishop. 
Barbara Culley. 



It was with deep regret that the news of 
Miss Golda Williams's death was received 
October 10, 1907. 

Miss Williams was a graduate of Centenary 
Hospital, in the class of 1906. She was a 
clever nurse as well as a kind and sympa- 
thetic one, and made many friends among 
those to whom she administered and of the 
people she met in a social way. 



Miss Ida Bender died at the Park View 
Sanitarium November 23, 1907. She was a 
graduate of Columbia Hospital, Washington, 
D. C, class of 1907, and had just been at 
Park View Sanitarium as head nurse since 
October 15. She had endeared herself to all 
who knew her. 



ADVERTISEMENTS 



FOR INFANTS— Mother's Milk or Benger's Food 

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and nearest thing is cow*s milk, modified by BENGER'S FOOD. 
C BENGER'S FOOD renders cow's milk easily digestible by even 
the feeblest infant, and at the same time adds valuable nourishing consti- 
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milk, and in the perfect control of these changes which it permits, 
BENGER'S FOOD is entirely different from any other food ob- 
tainable. Babies like it and thrive on it when nothing else agrees. 

NURSING M0THE:RS 

find BENGER'S FOOD an agreeable and valuable addition to the diet. 
It gives mzucimum nourishment, with minimum teoc on the diges- 
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superior to all other prepared foods and to mod- 
ified milk. 



BENGER'S FOOD, Ltd. 

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LAHONT, CORLISS ® CO., Sole Importers 




Send to-day for booklet and a gen- 
erous Pree Sample. 



One of the 
Essentials 

for the saccessful care of skin diseases, sur- 
gical cases and in the sickroom generally, 
Is pure soap — cleansluK thoroughly, quickly 
and absolutely without irritation. 

Glenn's 
Sulphur Soap 

is uniTersally recommended 'by physicians 
and surgeons because they recognize its per- 
fect purity and unsurpassed medicinal prop- 
erties. It is soothing, healing, antiseptic, 
and aids In restoring normal conditions. 

Sulphur has been for generations an un- 
failing household remedy. The pleasantest 
and most efficient way to use It is In 
Glenn's Sulphur 8oap. 

Sold by all druggists. 



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^ Jen I was receiving my nurse's training courst 
Id Denver, the nurses were compelled to wear rubber 
heels while on duty. The pittance we received with 
our training barely kept us in uniforms, and it was 
necessary we should economize in every possible 
manner. For some time I used cheap rubber heels, 
but I soon found the shoes would scarcely be worn 
until the heel would be completely worn out. My 
dealer advised me to have the O'SuIlivan put on 
my shoes. They wore three times as long, conse- 
quently were cheaper. They were more comfortable 
because thev were more elastic than the other 
cheaper heels. I informed the other nurses of them 
and It was not long until we used no other rubber 
heel but O'SulUvanV URS. JAMBS A. ARMOUB, 
Alliance, Neb. 

O'SULLIVAN RUBBER CO., ^SS 



When you write Advertisers, please mention Thb Trained Nubsb. 



iSoofe B^ebietosi 



Hospital Training-Sclwol Methods and the - 
Head Nurse, by Charlotte A. Aikens, late di- 
rector of Sibley Memorial Hospital, Washing- 
ton, D. C, late superintendent of Iowa Meth- 
od'st Hospital, Des Moines, and of Columbia 
Hospital, Pittsburg, associate editor of the 
National Hospital Record. Price $1.50 (net). 
For sale by Lakeside Publishing Company. 

This book is a pioneer in its special field. 
Though the list of text-books dealing with 
practical nursing is increasing almost monthly 
we have had nothing on the subject of meth- 
ods of teaching. That there is a great need 
for this there can be no doubt, for, as the 
author states, "experience and observation 
have shown that many capable graduate 
nurses who assume the responsibilities of 
teachers and head nurses have but a very 
vague idea as to their relation to the institu- 
tion, its officers, patients, physicians, pupil 
nurses and other head nurses." 

In the opening chapter . Miss Aikens tells 
us that "the ideal training is not that which 
covers tbe most ground, but that which fits 
a nurse to render the highest and best prac- 
tical service to the sick." The problem then 
to be solved is, What are the essentials? Pass- 
ing on to the chapter on the pupils, we find 
some valuable statistics, which bear on the 
subject of eligibility. Speaking of the high- 
school requirement she quotes the statement 
made by Howard Woolston in "Charities and 
the Commons," that "it is an indisputable fact 
that about ninety per cent of the pupils in 
the public schools leave before the high-school 
stage. Perhaps two-thirds of this number 
fail to complete the grammar grades," and 
also a statement made by a prominent edu- 
cator, that less than five per cent of the pu- 
pils in rural districts get any education other 
than that received in rural schools. In view 
of these facts the author believes that it is 
certainly perilous to fix an arbitrary educa- 
tional standard at the present time, or to limit 
the supply from which applications will be 
considered to less than ten per cent of the 
population, unless we are prepared to cease 
to depend on training-schools for routine 
nursing in hospitals. 



There is not a chapter in the book that 
does not contain valuable suggestions which 
we would like to call to the attention of our 
readers, would space permit. But we cannot 
refrain from noting Miss Aiken's apprecia- 
tion of the "human need" as shown in the 
chapter "The Head Nurse and Her Patients." 
In speaking of the entrance of a patient to 
the hospital she says : "A few sympathetic, 
reassuring words would mean more at that 
particular moment perhaps than at any other 
time in his life, but if the head nurse is too 
busy to speak them, if she has not trained 
her nurses to think of them, they will not 
be spoken. She should teach her nurses that 
to allay the unspoken questionings and fears 
is as important as the mechanic work to be 
performed for the patient, and can be done 
quite naturally in connection with it. To tell 
a patient at the trying period of entrance, 
for instance, that nearly everybody who comes 
here gets well, that everyone will do every- 
thing possible to insure a good recovery, 
that he will like the hospital when he gets 
over the strange feeling, may mean the dif- 
ference between peace of mind and mental 
distress. The neglect of such details does 
not always mean an absence of kindly feel- 
ing, but rather a thoughtlessness on the part 
of the head nurse that is deplorable. The 
very existence of the hospital reflects the 
desire of its founders, supporters and trus- 
tees to minister to human distress and bring 
comfort to the sick. It remains for the head 
nurse to interpret, in the truest manner pos- 
sible, the real spirit of the institution. To 
neglect it is to show clearly that she has a 
very imperfect understanding of the patients 
and their human needs." 

We heartily recommend this book to all 
those who are trying to solve the nursing 
problem. 

A Reference Hand Book of Obstetric Nurs- 
ing, by W. Reynolds Wilson, M. D., visiting 
physician to the Philadelphia Lying-in Char- 
ity. 32mo of 258 pages. Illustrated. Flex- 
ible leather. $1.25 (net). For sale by Lake- 
side Publishing Company. 

In this valuable little book the author pre- 



I 



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52 



THE TRAINED NURSE AND HOSPITAL REVIEW 



sents the subject of obstetrics in a definite 
and forcible manner, and the details, while 
not profuse, are sufficiently emphasized to fix 
themselves permanently in the reader's mind. 
The entire subject of obstetrics is treated 
from the nurse's point of view, and covers 
every question involved from the beginning 
of pregnancy through the puerperium and 
care of the infant. There are twenty-three 
short chapters, each dealing with a separate 
stage of pregnancy, labor, infant feeding, as 
well as presenting the anatomy of the birth, 
canal, presentation and position of the fetus, 
the management of normal and abnormal la- 
bor, emergencies and complications, surgical 
interferences, and in fact with every ques- 
tion likely to confront the nurse in her care 
of patients in the pregnant state. An impor- 
tant fact noted in this work is that the au- 
thor emphasizes the nurse's duties, and pre- 
sents the subject in a way best calculated to 
be of practical service to her. Sixty-one il- 
lustrations are interspersed in the text so as 
to make clear the prominent facts presented 
as well as illustrating conditions and devices 
often requiring pages of explanation. The 
index is full and comprehensive. The book is 
bound in flexible leather and the size adapted 
to fit the pocket. 



Home Care of the Sick, Part I. Lesson 
papers prepared by Amy Elizabeth Pope, in- 
structor in trained nursing, Presbyterian Hos- 
pital, New York City. Price, 8oc., postpaid. 
For sale by the Lakeside Publishing Com- 
pany. 

This book is one of the publications of 
the American School of Home Economics, 
Chicago, 111. 

As "The Trained Nurse and Hospital Re- 
view" has to do with trained nursing, an ex- 
haustive review of a work of this kind would 
be out of place in this magazine, but nurses 
often find women in the households in which 
Ihey nurse who desire to learn at least the 
rudimentary principals of skilled nursing 
simply for home use. This book is one of the 
books they could safely recommend. There 
is nothing in it new to the graduate nurse, 
but what is in it is exact, as might be pre- 
sumed to be the case with any book emanat- 
ing from Miss Pope. It is well printed, well 
illustrated, and the questions for self-exami- 
nation at the end of the chapters are decided- 
ly searching and useful. This is the text- 
book edition. There is a larger, better bound 
edition containing considerable extra material 
at $1.50. 



Springfield (III.) Hospital. 

An additional public hospital for Spring- 
field is provided for in the will of the late 
Colonel Stephen Logan Littler. The testa- 
ment creates a trust of the bulk of Colonel 
Littlcr's estate, which is said to amount to 
nearly $1,000,000. 

Provision is made for the payment of the 
net income to relatives and other beneficiaries 
until the death of the longest lived of the 
beneficiaries, when the entire trust estate is 
to become immediately available for founding 
and maintaining a new hospital. 

Twenty-five per cent of the value of the 
property may be used in purchasing grounds, 
erecting buildings, and equipping the institu- 
tion, and the remainder of the estate is to be 
retained by the trustee and the annual in- 
come is to be u.sed in maintaining the hos- 
pital. 



State Hospital for Little Cripples. 

With fitting formalities the new State Hos- 
pital School for Crippled and Deformed Chil- 
dren at Canton, Mass., was opened December 

I St. 

Nine large buildings, erected on a 6s-acrc 
lot 300 or more feet back from Randolph 
street, near Washington, compose the hospi- 
tal. There is an administration building, a 
hospital, a boiler and laundry house and five 
large dormitory and school buildings, all 
connected by a pergola or covered walk. This 
pergola i? so built that if necessary it can be 
closed, woodeh shutters being used. 

The superintendent, Dr. J. E. Fish, was for 
four years on the medical staff of the State 
Hospital at Taunton and the past six years 
director of the family care department of the 
State Board of Insanity. 



ADVERTISEMENTS 



TACHYPHAGIA has been declared to be our national vice ; and 
impaired digestive functions are a feature of many ills that flesh 
is heir to. The relative importance of pepsin or acid, achylia, 
hypo- or hyper-chlorhydria, while of interest to the clinician, is of less 
moment than the relief of the patient. Such corrective agents are to be 
exhibited as have been time-proven and found clinically not w^anting. 



LACTOPEPTINE 



(N.Y.P.A.) 



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Lactopeptine (N.Y.P.A.) is furnished in Powder (dose x-xx gr.). Tablets 
(dose 4-6), and Elixir (dose I tablespoonfui) after meals. 

Elixir Lactopeptine (N.Y.P.A.) will be found to be an elegant and efficient 
vehicle, earring in perfect solution and covering the taste of Bromides, Iodides 
Salicylates, Chloral, etc. 

THE NEW YORK PHARM. ASSOCIATION 

Samples on request. YONKERS. N. Y. 



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^*Antikamnia & Codeine Tablets'* in Grippal Conditions 

When you write Advertisers, please mention The Trained Nurbe. 



THE EDITOR IS NOT RESPONSIBLE FOR THE VIEWS OF CONTRIBUTORS 



The Increase in Charge at New Haven. 

To the Editor of The Trained Nurse: 

The recent increase in the charge by gradu- 
ate nurses at New Haven has been so gener- 
ally misunderstood and adversely commented 
upon that a statement of the conditions which 
existed, and the true purport of the so-called 
"fixing of rates," seems warranted. 

The charges for a nurse's service were on 
an unsatisfactory basis. The standard of 
$21.00 a week was a most elastic and variable 
one, with a growing system of extras and 
special prices for special diseases. The charge 
of $25.00 was generally understood for con- 
tagious cases and many and varied were its 
interpretations. Many nurses were charging 
it for typhoid, some few for tuberculosis, 
some for strictly quarantine cases only. An 
extra of $5.00 for fumigation was tacked on 
indiscriminately, according to the idea of the 
individual nurse. In case of death $5.00 was 
charged for assisting the undertaker in addi- 
tion to full time charge. Laundry and trav- 
elling expenses were regularly charged. Just 
what a nurse would cost was a most uncer- 
tain proposition, and the need of some uni- 
form and more professional base of charge 
was recognized by both the nurses and those 
who employed them. 

A plan was thought out and offered to each 
one of the nurses' homes, clubs and registries 
for consideration, and later an informal meet- 
ing was held, and the plan discussed and 
agreed upon. One account calls it a "special 
meeting," another infers that it was a State 
meeting, while in truth it was an absolutely 
informal calling together of the graduate 
nurses of New Haven. No notices of the 
meeting were issued by the press, nor was the 
State Association or either of the local alum- 
nae societies asked to act in the matter, though 
each one was well represented in the meeting. 
How the papers of the State received the 
news I do not know. It was unfortunate and 
regrettable. Either some nurse failed to under- 
stand, and this seems unlikely, or else was 
misunderstood and misinterpreted beyond the 
usual newspaper average. 



Just what was agreed upon was this : To 
charge $25.00 a week for all general practice, 
including, of course, typhoid and tuberculosis; 
to charge $30.00 a week for strictly contagious 
cases, those requiring quarantine. These 
charges are to include everything, all expenses 
of the nurse — except, of course, her board — 
for cases in the city; railroad fare to out of 
town cases is to be charged. 

It was generally accepted and agreed upon 
as being a fair arrangeinent. It was done 
simply to eliminate the unprofessional charg- 
ing of expenses, and to make such a charge 
as would on the average balance them, and 
also to establish a uniform classification of 
cases — an honest effort to become more pro- 
fessional and more business-like. No one is 
restrained in any way from doing absolute 
charity work or lowering her charge if con- 
ditions appeal to her as worthy of that con- 
sideration. On the other hand, there is no 
authority to prevent any nurse from charging 
the "extras" as before, but such action 
would be much deprecated by the large per- 
centage which stands for a square deal. 

I hope I have put our meaning and inten- 
tion clearly, for it is a matter of regret that 
it has been so misunderstood. If the action 
of the Virginia nurses has received equal mis- 
interpretation we extend cordial sympathy. 
A New Haven Nurse. 



Raising the Rate in New IHaven. 

To the Editor of The Trained Nurse : 

In regard to the nurses of New Haven 
changing their price from $21 to $25 per week, 
would like to explain that it was not at a 
State association or alumnze meeting that this 
action was taken. Unfortunately, in New 
Haven we have no county association, so sev- 
eral of the nurses who for many reasons 
believed our work to be worth $25 per week 
formed a committee, and carefully searched 
the city directory and diligently inquired 
about the location of graduate nurses. Then 
they invited all that they could locate to meet 



ADVERTISEMENTS 



GUARANTEED UNDER THE FOOD AND DRUGS ACT, 
JUNE 30, 1906— SERIAL No. 110 



ALETRIS CORPIALRIO 

Indications: Amenorrhea, Dysmenorrhea, Icu- 
corrhea. Prolapsus Uteri, Sterility (from func- 
tional causes) and To "Pre-Oenl Miscarriage 



CELERINA 



Indications: As a Tonic, Stimulant and Anti- 
spasmodic : in Loss of Nerye Power and in 
All Languid Conditions of the System 



PINUS CANADENSIS (Kennedys) 

Indications: DARK.-- In Albuminuria, Diarrhea, 
Dysentery, Night Sweats, Hemorrhage and 
Profuse Expectoration — also for Protruding 
and Itching Piles, Fissures of the Anus, Burns, 
Scalds, Catarrh, Sore Throat and Tamponing. 
LIGHT.— For Gonorrhea, Gleet, Leucorrhea, 
and other Vaginal Conditions— also for all 
Diseases of the Mucous Membranes requiring 
an Astringent 



RIO CHEMICAL CO. 



LONDON- 



-NEWYORK- 



■PARIS 




Combination 

Safety 
Pocket 

Made Especially 
for Nurses 



THE COMBINATION 
SAFETY POCKET 
'or three pockets in 
one) consists of a watch 
pocket, suspended from 
which are two additional 
pockets, oblong in shape, 
one acting as a holder for 
the fever thermometer, the 
other for fountain pen, pen- 
cil or any article desired. It 
is made especially for the 
nurse and lady physician. 
and is indispensable for the 
sick room. Easily and se- 
curely adjusted to the belt. 
Convenient, durable and 
safe. Made of genuine high- 
grade leather, handsomely 
embossed, and of superior 
workmanship. Made only 
in black. Cannot be bought 
in the stores. Sent by mail, 
postpaid, upon receipt of 

$1.00 

Illiistr.iteii circular 

SAFETY POCKET CO. 

1270 W. Polk St. 
Chloatfo 



THIS BABY WAS FED ON 

EsKAY's Food 

'--^"^ "SINCE HE WAS 5 
WEEKS OLD. HE 
♦ HAS NEVER BEEN 
-m SICK A DAY. 

^.*AT 12 MONTHS 

HE WEIGHED 

28 POUNDS." 



WM. H. BURLEIGH. CHESTER. MASS. 

Thousands of sturdy children 
owe their present rugged health 
to the use of Eskay*s Food in 
infancy. It prevents intestinal 
disorders and is a positive tissue- 
and energy-builder. 



Every nurse should know why \ 
Eskay's Food is " the most effective 
and economical modifier of cow's 
milk." 

This is explained in our helpful 
book, "How to Care for the Baby," 
a cloth-bound copy of which, to- 
gether with samples of Eskay's 
Food for trial purposes, will be 
gladly sent on request. 



SMITH, KLINE & FRENCH CO. 
436 Arch Street, Philadelphia 



Wheu you write AdvertlHtTB, pleuse mention Thh Tbained Nubsb. 



56 



THE TRAINED NURSE AND HOSPITAL REVIEW 



^^at-ii stated time to take up the matter. One 
hospital superintendent, when asked where her 
graduates were located, replied that she did 
now know (the nurse out of courtesy had ex- 
plained her reason for wanting to reach this 
hospital's graduates). Therefore only one 
graduate of this particular school was present 
at the meeting. But among the nurses who 
were present there were graduates of about 
^ ^n different hospitals located in New York, 
^^H>ssachusetts and Connecticut. It was this 
'^^representative body of women who voted 
'^'"' unanimously to raise the price. There are a 
few weaklings in the profession here who evi- 
» dently cannot decide for themselves what 
price to charge, and have to call up their 
former superintendent and ask whether or 
not they shall charge $25. These same weak- 
lings will continue to work for the old price, 
beciuse their former superintendent, who 
knows nothing about private work from 
actual experience, tells them $21 is enough to 
charge. 

if every woman doing private nursing 
would belong to her alumns and attend the 
meetings as regularly as possible she would 
there meet women who could intelligently dis- 
cuss the pros and cons of private work. The 
majority of women who excel as teachers 
and have been the means of uplifting the 
standard of training schools cannot fully un- 
derstand the work of the private nurse (never 
having worked outside of a hospital) ; there- 
fore a superintendent is not competent to de- 
cide what private nursing is worth. In the 
course of each year private duty nurses give 
several days', or even weeks', work for char- 
ity, but, with a true charitable spirit, they 
say nothing about it. 

The business people of this city say that 
nurses should have $25 a week ; that the num- 
ber of hours we work and the many priva- 
tions we of necessity put up with are well 
worth it. 

A Private Duty Nukse. 
+ 
Her Individual Affair. 

To the Editor of The Trained Nurse: 

May I have the privilege of your columns to 
enter protest against this never ceasing clamor 
about the establishment of a standard fee, and 
when and where and how the nurse shall fit 
the wage to the means of the employer. The 



"News Letter," of Waltham, says: "A nurse 
who refuses to go out for less than $21.00 
under any circumstances is not doing her 
duty." Her duty to whom? Is not the nurse 
an individuality who is to choose for herself 
her own code of right and duty? We say of 
the layman, "He isn't neighborly," or, "He 
isn't charitable," if he doesn't help out when 
some family is in trouble, but of the nurse, 
"She doesn't do her duty !" 

I do nursing primarily as the business by 
which I earn my living. If I do it because I 
like to do it, and feel that I am fitted for it, 
and can do it better than I can do any other 
work, why isn't that sufficient? What more 
is required of me than honest effort to do well 
the work I have chosen? And then let me 
stand or fall according to my merit. 

Call nursing a profession, a vocation, or 
a business — what you will — the great majority 
of us are doing it as a means of livelihood, 
and to my mind whether I do charity work 
or absolutely refuse to do it is my own pri- 
vate individual affair as much as it is the 
man's prerogative to give or refuse to give 
to the beggar on the street. No one, no asso- 
ciation, has a right to establish a "rule" con- 
cerning my charges. What I charge is my 
personal affair, a business agreement with my 
employer. If my sense of fellowship causes 
me to agree with my co-workers on a uni- 
form charge, or if I connect myself with a 
registry having a fixed rate, I am in honor 
bound to live up to my aj^reement, but only 
that. Accepting a money present in excess 
of the rate or giving free weeks of service is 
a childish sort of evasion. Tommy's mother 
told him not to go out of tlie gate. He obeyed 
her, and climbed over the fence. 

If Miss Jones will work for $21.00 and 1 
stand for $25.00, let it work itself out If I 
am worth $4.00 more than she is, let me prove 
it. If I'm not, let me go to the wall. I con- 
sider the commodity I have for the market 
worth $25.00. Take or leave it! Call it pro- 
fessional service, attendance or work as you 
will ; it is a commodity on the market, and to 
be bought. It will be paid for or a cheaper 
article proven as good according as it is or is 
not of merit. 

Why should nurses be ever subject to dic- 
tation as to what they shall or shall not, 
ought and ought not, may and may not charge, 
think, say, do, give, withhold, eat or drink? 
We are dictated to by hospitals, training 



ADVERTISEMENTS 



n; 



ToThm VIh\ch \s GoooV 



WHEN a Physician learns by experience 
that a certain remedy produces positive 
results, he becomes familiar with its indications, 
limitations and therapy, and therefore wants 
no substitute or make-shift dispensed when he prescribes it} 
When a Physician has for a long time prescribed 

AS A BLOOD BUILDER IN 

Ansmia, Chlorosis, Rickets, Amenorrhoea, Dysmenorrho^a, Chorea, Bright's Disease, &c^ 

he knows by experience that it is a standard of therapeutic worth and wants no other. 

BUT SOMETIMES THE PATIENT DONT GET IT. DOCTOR! 

To assure the proper filling of your prescriptions, order Pepto-Mangan "Gude" in original bottles. 

IT'S NE^VEM* jSOEv^D 11* BUH^K. 

M. J. BREITENBACH COMPANY, 

Laboratory I 

Leipzic, Germany;^ New York. 





PUNY BABIES 

often develop into sturdy children, if properly nourished. Marasmus is frequently 
due, no doubt, to faults of metabolism; but it may be, and not infrequently is, 
caused by lack of proper nourishment, the natural forces of the child being very 
ready to respond if only suitable pabulum is offered it. The choice of the proper 
food is a question of the highest importance, yet it is only too often lightly decided 
by unthinking persons by the choice of a food which does not furnish the nutriment 
demanded by nature to develop the strong and healthy child. 

LACTATED INFANT FOOD 

provides every constituent required by nature tor the sturdy, healthy development 
of the growing child. It approaches mother's milk more closely than any other 
food. Its nutritive constituents are combined in such proportions that any variety 
of combinations can be readily made by Physician, Nurse or Mother, to meet 
every condition and requirement for the proper feeding of the baby. Lactated 
Infant Food has been used by thousands of physicians everywhere, not only in 
practice, but in their own homes. 

The extensive experience of countless physicians is its strongest testimonial. 




PhyticUnt who wiah to tfive Lactated 
Ini&nt Food a carefal trial majr have 
samples tent direct to patients by for- 
warding to as names and addresses. 


Wells ^ Richardson Co. 

BURLINGTON. Vt. 









58 



THE TRAINED NURSE AND HOSPITAL REVIEW 



schools, nursing journals, State associations, 
doctors and first, last and always, by laymen, 
about all these things. 

I elect to be a free lance. There are, it 
is true, conventions in our profession in its 
various relations which I respect, and to 
which I conform, but I believe that if my 
perception of what is fair and square, from 
a business, ethical and professional viewpoint, 
is erratic, it will prove itself so effectually, 
and show me my error just as plainly as any 
method of rule or regulation. 

An Independent Nurse. 

+ 
Menstrual Flow In' Infants. 
To the Editor of The Trained Nurse: 

Will you, through the columns of The 
Trained Nurse, please tell the cause, or at 
least explain the reason, for a menstrual flow 
in a new born babe? I know of three cases 
in one family where I have nursed. 

A Graduate Nurse. 

Dr. Joseph B. De Lee, in his book Obstet- 
rics for Nurses, says: "Once in about fifty 
cases of female infants a bloody, apparently 
menstrual, discharge appears on the napkin. 
In one case it was so profuse that the little 
one's health was affected. She was listless 
and limp for a few days. The bloody dis- 
charge almost never means anything patho- 
logic, but it may, and should therefore be 
promptly reported. Treatment is usually un- 
necessary. In the case cited ar drop of ergot 
was given three times." — Ed. 

+ 
A Correction. 

To the Editor of The Trained Nurse : 

Investigation proves that an error was made 
in the report of our delegates to the conven- 
tion of the Associated Alumnae of the United 
States, held at Richmond in May, and printed 
in our Johns Hopkins Hospital Alumnae Mag- 
azine of August, quoted by The Trained 
Nurse, but incorrectly quoted, in its October 
issue. The chairman of our committee wrote 
regarding the material of the Journal's pages, 
"some of that now appearing," etc. You 
omitted the qualifying adjective, and so added 
to the injustice done theAmerican Journal of 
Nursing by our delegate in seeming to report 
as an official occurrence what did not take 
place at Richmond. The Associated Alumnae 
in no way recorded a want of approval of 



the American Journal of Nursing, and our 
delegate gave her own impression of what she 
got from the conversational criticism that al- 
ways floats about in the atmosphere of large 
gatherings. Her statements, unfortunately, 
were not so worded as to make this clear. 
The Johns Hopkins Hospital Alumnae Asso- 
ciation begs that, in order that the correction 
of their apparent criticism may reach without 
further delay the same audience as the edi- 
torial in The Trained Nurse, this periodical 
may find space for its immediate publicat'on. 

Mary Cloud Beau. 
President Johns Hopkins Hospital Alumn.x 
Association. [See editorial.] 

+ 
Underfeeding Nurses. 
To the Editor of The Trained Nurse: 

It is an outrage upon womanhood the way 
nurses at the average hospitals are fed, or, 
rather, underfed. Not only is this true of the 
average hospital, but this outrageous fact ap- 
plies to seven out of every ten hospitals. Even 
in cases where a hospital in its medical de- 
partment may rise to the very highest stand- 
ard the meals served to the nurses are, in 
the variety, cooking and nourishing quality 
of the foods, of the most unintelligent and 
inferior order. But this is a part of the hos- 
pital that the public does not see. So preva- 
lent has this custom of ill-feeding the hospital 
nurses become that the hospital superintendent 
who takes cognizance of the nurses' dietary 
is to-day the exception. Brush aside entirely 
the inhuman phase of this wrong, and no 
policy could possibly be more short-sighted. 

The work of the physician is, of course, 
the most important in a hospital ; but close to 
his work — and we are not straying from the 
truth when we say almost equal to it — is that 
of the nurse. In fact, so far as the patient 
is concerned, the work of the nurse is even 
more important on the score of her almost 
constant presence at the bedside. And not 
only does that presence mean constancy, but 
it must also mean cheerfulness. A nurse is 
always expected to be sunny in her dispo- 
sition. She must have the patience of Job. 
She must be tireless to do. Her hours are 
long. 

All these qualities, of which she is sup- 
posed to give freely, are no small drain upon 
the physical vitality, especially that of a 



ADVERTISEMENTS 



Antithermoline 

A Superior Surgical Dressing 
Made from the best quality of imported Welsh Kaolin 



(Reduced Size] 




A most effective application in all conditions of irritation, 
congestion, and inflammation. Now sold in screw top glass jars 
which can be resealed. 



FREE to Nurses— NURSES' HANDY BOOK, containing 
much valuable data and useful information connected with a nurse's duties. 



G. W. CARNRICR CO. 

42 Stillivan Street :: :: New YorK Citx 

When you wrlN; AtlvcrUsorH, pleiiHo mt-iiliou Tiii"; 'ri(AiNici) Nuksb, 



60 



THE TRAINED NURSE AND HOSPITAL REVIEW 



woman. But men or women, we are all human 
beings, and there is precious little difference 
in sex when it comes to the nourishment we 
require for our bodies. To work well we 
must be fed well, and the more exhausting 
and exacting the work, the more nourishing 
the food we require. Hence the dietary of 
the nurse should be a matter of the most im- 
portant consideration, instead of, as it is to- 
day, being considered practically of no im- 
portance whatever. 

It is a common remark among resident doc- 
tors that they would not stand the stuff that 
is put before the nurses. There is not one 
scintilla of doubt that if these nurses were 
men the present order of things would soon 
change of compulsion. And this is where the 
unfairness of the situation comes in. It is 
because these nurses are women, proverbiaHy 
long-suffering and less prone to complain, that 
they arc compelled to endure what men would 
not tolerate. Nor it this stricture either un- 
fair or too harsh when the significant fact is 
considered that in the women's hospitals 



throughout the country the dietary of the 
nurses is notoriously bad. 

This careless treatment of a class of pecu- 
liarly hardworked women should not be al- 
lowed to go on. There is work here, and 
splendid initiative work, for the nurses who 
read these words — those who have the author- 
ity and the self-assertiveness to put it into 
execution. 

The work of the nurse touches the lives of 
the public in a peculiarly sensitive and inti- 
mate way. Many owe much to her, and the 
least she may have is "fair play." To that 
she is surely entitled, if any one' is. But she 
is not getting it. 

As a personal remark I wish to say that as 
superintendent of nurses in a small hospital 
my lot has been very fortunate in regard to 
the dietary — unusually so. But memories of 
my training in two hospitals justify the as- 
sertions made above, and my sister nurses 
who trained with me will heartily indorse 
this statement. 

Marion Whitten. 



Guild of St. Barnabas, Orange Branch. 



A regular monthly service and meeting of 
the Guild of St. Barnabas was held at the 
Church of the Holy Communion, South 
Orange, on the afternoon of October 31. This 
being the day previous to All Saints Day an 
address appropriate to that day was made by 
Archdeacon Cameron, rector of the chucrh. 
In his address Mr. Cameron defined saints as 
those who had come out of great tribulation. 

Before the close of the service four candi- 
dates were received into membership — one 
active member, one a priest associate, and two 
lay associates. 

A,fter service all assembled in an anteroom 
to the church, where a business meeting was 
conducted with the Chaplain in the chair. The 
report of Miss Hayden, delegate from the an- 
nual council, recently held at Washington, was 
one of the important features of the meeting. 
We had the pleasure of listening to a full 
and interesting account of the convention. A 
complete report of tlic convention will prob- 
ably appear later in The Trained Nurse. 



The Secretary of the Sick Relief Associa- 
tion urged that more Guild members join tliis 
branch of the (iuild, and stated there had been 
more sick benefits recently paid tlian had been 
for a long time past. She further urged that 
the Guild room at the Valley Settlement be 
used more by the nurses. 

Twenty dollars was voted to be placed in 
the hands of the Work Connnittee to carry on 
the work during the winter, it having been 
decided at a previous meeting that the Guild 
work this winter for the prospective summer 
cottage at Bradley Beach. 

Mrs. Vincelette reported that the funds of 
the Anti-Tuberculosis Committee were low and 
proposed that the Guild help that society by 
holding a cake sale. The motion was carried 
and a committee appointed to conduct a cake 
sale at Grace Church parish house. 

At the close of the business meeting the 
Rev. Mr. Cameron invited all to refresh- 
ments in the basement, where a pleasant so- 
cial time followed. 



ADVERTISEMENTS 



The 



'Jllenburgs Foods. 



Provide nourishment suited to the needs and digestive powers of the child from birth 
onward, according to the development of the digestive organs. 

THe •• Allen burys" MilK Food ''No. 1" 

Designed for use from birth.to three months of age, is identical in chemical composition with 
maternal milk, and is as easy of assimilation. It can therefore be given alternately with the 
breast, if required, without fear of upsetting the infant. 

THe "Allenburys" MilK Food ''No. 2" 

Designed for use from three to six months of age, is similar to "No. 1," but contains in 
addition a small proportion of maltose, dextrine and the soluble phosphates and albuminoids. 

THe ••Allenburys" Malted Food ''No. 3** 

Designed for use after the fifth or sixth month, is a partially predigested farinaceous food need- 
ing the addition of cows' milk to prepare it for use. 

Physicians familiar with the "AUenburys" Series of Infant Foods pronounce this to be the 
most rational system of artificial feeding yet devised. Their use saves the troublesome and fre- 
quently inaccurate modification of milk and is less expensive. Experience proves that children 
thrive on these Foods better than on any other artificial nourishment 

SAMPLE AND CLINICAL REPORTS SENT ON APPLICATION 



THE ALLEN ^ HANBURYS CO., Limited 

TORONTO. CAN. LONDON. ENG. NIAGARA FALLS. N. Y. 



^.|.4.^«^^..^4.^.4.^.|«^.|..|«|.^^.[.^.^^.|.^>^^.^.t,.«,^,.|.^...|..«^. j .. | .. j .. j .^^^^ 



A Drink in Fevers 



A teaspoon of Horsford's Add Phosphate added J 

to a glass of cold water makes a cooling and refresh- J 

ing acidulous drink for the patient during conva- ;j; 
lescence from typhoid and other febrile conditions. 

Its superiority over Dilute Phosphoric Acid, or 
any other acid, is due to the fact that it contains the 
phosphates of calcium, sodium, magnesium and 
iron, which means increased nutrition. 

Horsford's Acid Phosphate 

is more palatable and strengthening than lemonade, 
lime juice or any other acidulous drink. 

RUMFORD CHEMICAL WORKS, Providence, R. I. 

t 

^••H•4^^•^••M••^•^♦^•H+^••H••^•^•H••HH"H••^•^•M~H••M••^•^^ 

Wlicii y<Mi wiil)' AdvcrliHorH, idciiHc niciitioii Tiii'; 'I'iiained Nuii.sk. 



iBleto BemeDiesi ant. ^pltanceei 



A Generous Offer. 

Have you accepted the offer of the Pulvola 
Chemical Company, 60 Beekman street, New 
York, to send samples of Pulvola Toilet Pow- 
der to those who wish to know the real differ- 
ence between their baby powder and the talc 
powders? 

+ 
Never Without Them. 
I have been using Resinol Soap and Salve 
for the past ten years in my home and prac- 
tice, and am never without them. They give 
mc entire satisfaction. Have never found any 
rther soap or ointment to equal them. 

John W. Turley, M. D., 
Desloge, Mo 
+ 
Nauheim at Home. 
The Nauheim bath is essentially a salt-water 
bath properly carlwnated. The use of the 
Triton Effervescent Bath Salts renders its 
preparation at home simplicity itself. The 
Triton Salts come in packages, each package 
being sufficient for one bath, and containing 
full directions. See advertisement in this issue. 

'V 

Wants Some More. 

Belleville, 111., March 20, 1907. 
Obden & Shinier, Middletown. N. Y.: 

Dear Sirs — Received the sample of Mystic 
Cream. Think it is fine. Would like a large 
jar. Enclosed please find 2> cents in stamps. 
And oblige, Miss ^ — — . 

(Name furnished on application.) 

+ 
Regulin, for Chronic Constipation, 
is simply ideal — being devoid of taste, nor im- 
parting such to any vehicle — apple-sauce, 
maslied potatoes, breakfast foods, etc., and, 
furthermore, being perfectly harmless, is easily 
taken by young and old. Its effect is — 
carrying moisture to the hardened fecal 
masses and making them voluminous. Per- 
fect cures of this obstinate trouble can be 
effected. To physicians, druggists and nurses 
tliree packages of Regulin are delivered for 
$1.00 by The Rein.schild Chemical Co., 71 
Barclay street, N. Y. 



Horlick's IVIalted Milk Toast. 

Pour a cup of Horlick's Malted Milk (made 
by dissolving at least two heaping tablespoon- 
fuls of Malted Milk powder) over two pieces 
of toast, and let stand on back of the stove for 
fifteen or twenty minutes. Zweiback can be 
used in place of the toast. Serve warm. 

Send for a free sample of Horlick's Malted 
Milk and try it yourself. 

+ 
Sexual Neurasthenia. 
This distressing and frequently intractable 
malady is logically and successfully treated by 
the admini.stration of Gray's Glycerine Tonic 
Compound. It does not act by temporary 
stimulation of weakened function^, but pro- 
duces permanent benefit by its influence on 
the whole bodily nutrition. The nervous sys- 
tem is restored to a normal equilibrium and 
morbid fears are dissipated. 

+ 
Used Almost Daily. 
About two years ago I liad a ca.se of burn 
in which I first made use of Unguentine. 
From that time on I have used it almost daily 
in my practice, with results more than pleas- 
ing to me and my patients. I have had a 
dozen or more extensive burns, and in no case 
has the effect of its use been disappointing. 
W. S. GiLRov, M. D., 
Baltimore, Md. 

+ 
Little Giant Ice Crusher. 
This little njachine is intended for house- 
hold U.SC or for a limited quantity of crushed 
ice. It operates easily and does the work 
quickly. The crushed ice is of a very uniform 
size. Either a small piece or a piece that fits 
the hopper will go straight through. It is 
built very substantially and will give years of 
service; nothing about it to get out of order. 
It is constructed so as to be convenient to set 
up and can be placed anywhere. It is pro- 
vided with a pan to receive the crushed ice. 
Size : Hopper, 4x6 inches ; height, 18 inches ; 
weight, 30 pounds. Price, $7.50. See adver- 
tisement in this issue. 



ADVERTISEMENTS 



The Dangers of Cow's Milk 

THE recent epidemic of Scarlet Fever In Chicago has awakened the whole 
country to the grave danger lurking in the Milk Supply of our large 
cities. Wherever milk is used that has not been properly safeguarded 
from the cow to the consumer, the infant mortality will always be high. 

Coincident with the Chicago Epidemic there comes a Report of the British 
Royal Commission on Tuberculosis. After five years' investigation, the Commis- 
sion confirms the theory of Von Behring, that the tuberculosis of cows is a con- 
stant menace to the human race, and that consumption developed In later life, 
has often been contracted In infancy, from tuberculous milk. 

Nestle's Food 

does not require the addition of milk in preparing it for use, as it Is a complete 
diet in itself. The basis of Nestle's Food is cow's milk, so treated and modified 
that it will be easily digested, and will resemble mother's milk in its composition, 
as closely as possible. The milk supplied to the Nestle Factories is collected 
under the most rigid precautions, from cows that are under the constant super- 
vision of the Company's Veterinarians. Furthermore, the process of manufacture 
completely sterilizes the milk. This Is fully set forth in our pamphlet, "Recent 
Work In Infant Feeding." A copy of this, with samples of Nestles Food, we will 
be glad to send to any physician. 

HENRI NESTLED, 72 Warren St.. New YorR. 



INSTRUCTION IN MASSAGE 

THE SYSTEM YOU WILL EVENTUALLY LEARN 

Sw^edish Movements, Medical and Orthopaedic Gymnastics 

Term: 3 Months Tuition Fee, $60.00 

Course in Electro-Therapy 

Term: 2 Months Tuition Tee. $25.00 

Course in Hydro-Therapy in all its Forms 

Term: 6 Weeks .' .... Tuition Tee, $50.00 

WINTER CLASSES OPEN JANUARY 21, '08 
6793 TREATMENTS GIVEN IN 1900 

No Bettor Clinical Exporlonce Possible 

All courses may be commenced at the same time and finished within three months. 

The instruction consists of daily clinical work and practical lessons on patients referred to our clinics from 
the various Hospital Dispensaries. Original Swedish (Ling) system, and Weir Mitchell's Rest-Cure system. 
All pupils attend clinics at several city hospitals. Payments can be made to suit your convenience. Particulars 
and illuitrated booklet on Massage upon request. An early application for admission is advisable. 

INSTRUCTORS 



T. D. Taccakt. M.D. (Jeflferson Med. College). 

Wm.Ebwin, M.D. (Hahnemann and Rush Med. Col. J 

Frank B. Baibd, M.D. (Univ. Pennsylvania). 

Max J.Walter (Royal Univ. .Breslau, Germany, and 
lecturer to St. Joseph's, St. Mary's, Mount Sinai 
and W. Phila.Hosp.for Women, Cooper Hosp.,etc). 



Helene Bonsdorff (Gymnastic Institute, Stock- 
holm, Sweden). 

LiLLiE H. Marshall HPennsylvania Orthopedic 

Edith W. Knight j Institute). 

Helen T. Walker (St. Francis Xavier's Infirm- 
ary, Charleston, S. C, Penna. Orthop. Inst.). 



Pennsylvania Orthopaedic Institute and School of 

Mechano-Therapy (incorporated) 

1711 Green Street, PHILADELPHIA. PA. MAX J. WALTER. Superintendent 



64 



THE TRAINED NURSE AND HOSPITAL REVIEW 



"Tri-Cel" Hot Water Bottle. 

Is indestructible and will not suffer from 
boiling water. Will bear the weight of the 
patient without leaking or straining. Can be 
sterilized surgically clean by boiling. Is equal- 
ly adapted to hot or cold applications. Will 
maintain an even temperature for an indefi- 
nite period by changing one cell at a time with- 
out removing the bag from the patient. Is a 
combined article which will last a lifetime for 
the price of one ordinary bag. 

♦ 
Evans's Throat Pastilles. 

Miss Marie F. Gaul writes: 

Peabody Conservatory, 
Baltimore, January i8, 1901. 

"It gives me pleasure to say that at last I 
have found throat pastilles that are really 
efficacious. My pupils also agree that your 
Antiseptic Throat Pastilles are the best they 
have ever used." See advertisement in this 
issue." 

+ 
Something New for Nurses. 

There has just been put on the market 
something new for the nurse and lady phy- 
sician. It is in the nature of a combination 
safety pocket, or three pockets in one, rather, 
whereby the wearer can carry her watch, fever 
thermometer, fountain pen, pencils or any 
other articles desired. It is made of fine 
leather, handsomely embossed, easily adjusted 
to the belt, and so constructed that articles 
cannot fall out It is a very useful and con- 
venient invention and indispensable for the 
sick room. Circular can be had by addressing 
the Safety Pocket Co., 1270 W. Polk street, 
Chicago, III. 

4^ 
Eminent Authority. 

Dr. William A. Hammond, late Surgeon- 
General, U. S. A., said : ''When I have suc- 
ceeded in curing the patient, I continue the 
administration of the phosphates for a long 
time afterward, to provide for any deficiency 
which may exist. I know it does no harm, as 
the surplus is excreted." 

Horsford's Acid Phosphate should not be 
confounded with any kindred preparation com- 
pounded by druggists or in the laboratory. It 
is not made by mixing the ingredients to- 
gether, but is obtained in the form in which 
it exists in the animal system. 



Produce Desired Action. 

The scientific researches of Hamburger, 
lUmge and others, conducted during the past 
twenty-five years, have shown the immeasur- 
able superiority of the organic compounds of 
iron and manganese. The organic compound.s 
alone have been found to be absorbable in such 
amounts as to produce the desired action on 
the blood. Of these compounds the peptonate, 
which is an organic-chemical combination of 
iron and manganese with peptone in a solution, 
known as Pepto Mangan (Gude), is the most 
roadily absorbed, and therefore the most effi- 
cient preparation of iron-manganese known, 
and as such is used witli the greatest benefit 
in convalescent anemias. 

+ 
"Worked Like a Charm." 
The Anasarcin Chemical Company : 

Gentlemen — In reply to yours of the 2Sth 
inst., will say the <iample package of Anasarcin 
tablets was received. I gave them in a case 
of cirrhosis of the liver with ascites, in which 
I had tried the. usual remedies without any 
apparent effect. I had decided to tap the 
patient when my attention was called to your 
remedy, and, although very skeptical about its 
being of any benefit, I gave it a trial. It 
"worked like a charm," entirely relieved the 
ascites, and a month has now elapsed and there 
has been no return of the trouble. Yours 
truly, C. A. Chaloner, M. D. 

+ 
Relief in Rheumatoid Conditions. 

"Every physician knows full well the ad- 
vantages to be derived from the use of anti- 
kamnia yi very many diseases, but a number 
of them are still lacking a knowledge of the 
fact that antikamnia, in combination with vari- 
ous remedies, has a peculiarly happy effect. 
Particularly is this the case when combined 
with salol. Salol is a most valuable remedy 
in many affections, and its usefulness seems 
to be enhanced by combining it with anti- 
kamnia. The rheumatoid conditions so often 
seen in various manifestations are wonder- 
fully relieved by the use of this combination." 
—Dr. Pettingill, New York City. 
+ 
Nervous Neuralgia. 

Dr. Francis E. Anstie, a well-known London 
physician, describes neuralgia as "a disease of 



ADVERTISEMENTS 



.r";;^^ 



m.. 



-jrmm> 



m^: 



' r^ilA 



^^ 



^^"."•I-y 



-r^S^. 



i\ire Milk for €ie Baty 




^3r;;: 



can be secured only with great difficulty in moft cities, and often the smaller 
communities are no better served. 

Milk once contaminated cannot be made suitable for infant feeding. No amount 
of pa^eurization, Realization or modification can make poor milk a good infant food. 
The fundamental que^on in infant feeding is one of pure milk — safe milk. 

Highland 
Evaporated Milk 

is obtained from finely bred cows living under the moft favorable conditions of model 
dairy farms. The pure full-cream milk is te^ed, to ascertain if up to our ftandard, 
Rerilized, evaporated (reduced two and one-half times), placed in aseptic cans and 
again Rerilized. For infant feeding it possesses many advantages. The quality 
is uniform, the casein is more easily dige^ed than that of raw, pa^eurized, or boiled 
milk; it can be modified as desired and is absolutely pure. 

As it is beyond human skill to secure absolute uniformity in the full output of our 
large fadories, we are marketing our second grade at slightly lower prices as 

Pet Evaporated Milk 

it is but a trifle lighter and less con^ant in consi^ency than our HIGHLAND 
brand. It answers where scientifically exact feeding is not required. 

We are the originators of Evaporated Milk in this country, 
and our two products are the Randard of quality. They offer the 
simple^, moft uniform and satisfactory sub^itute food for infants 
and may also be used in place of dairy milk for all household 
purposes. 

Trial quantity on requeA. 



HELVETIA MILK CONDENSING CO., 
Highland. 111. 






When you write Advertisers, please menllou Tjjk Tuainkp Nuus*;. 



66 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the nervous system, manifesting itself by 
pains, which, in the great majority of cases, 
are unilateral, and which appear to follow ac- 
curately the course of particular nerves, and 
ramify, sometimes into a few, sometimta into 
all, the terminal branches of the nerves." It, 
is readily observed how such a disease per- 
meates and controls the entire nervous organ- 
ism, and to be eradicated some remedy that 
directs its sedative force against the central 
ganglia must be employed. Such a remedy is 
Daniel's Concentrated Tincture Passiflora In- 
carnata. Its action on the nerves is direct 
and potent, and, unlike the opiates, leaves the 
mind and bodily organs in bettor condition 
when its effects subside. 



"Born to Blush Unseen." 

Full many a flower is born to blush unseen 
'tis true, but, on the other hand, full many 
another flower that is not a child of ob- 
scurity, becomes a victim of arrested develop- 
ment and loses the glory that blushed and 
bloomed. 

Obscurity is hard to beat therapeutically, 
but arrested development will often respond 
to an impulse given to the life forces. Many 
a run-down, anemic child, many a young girl 
who seemed to be going into a decline, is 
pulled back into shape by the timely adminis- 
tration of a good reconstructive tonic; and of 
these there is none more effective than Wam- 
pole's Preparation of Cod Liver Extract. 
The alkaloids of cod livers seem to have a 
powerful effect upon the centres of nutrition 
and assimilation. 

+ 
Never Disappointed. 

While I have had occasion to use Ergoapiol 
(Smith) in very many cases, I cannot recall 
a single instance where I have been disap- 
pointed in the results hoped for. 

A commendable feature observed is the pos- 
sibility of following the administration of this 
remedy until the desired physiological effect 
is obtained without producing any unpleasant 
or depressing symptoms. 

In Ergoapiol (Smith) I have the fullest con- 
fidence that you will find a remedy possessing 
the highest therapeutic value in the treatment 
of amenorrhea, dysmenorrhea, fetid, scanty 
and suppressed menstruation, for in forty 



years of practice I have not experienced the 

same satisfactory results with any other drug. 

J. E. Du Vall, M. D., 

Kansas City, Mo. 

+ 

A Generally Useful Antiseptic. 

Tyree's Antiseptic Powder is one of the 
most generally useful antiseptic powders for 
hospital practice or in the office local treat- 
ment of leucorrJKea arising from various 
causes, as uterine anil vaginal catarrhs, that 
has ever been introduced. It is valuable in 
gonorrhoea, gleet, dysentery, catarrhal inflam- 
mations of the nose, throat, mouth, gums, etc 
Dr. W. M. Gray, Microscopist to the Army 
Medical Museum at Washington, D. C, by 
tests, has proven conclusively its bactericidal 
action as to the anthrax bacillus, the staphy- 
locci of pus, etc. While it may be applied as 
a powder, when circumstances demand, the 
economy of its use consists in the fact that 
water (so as to make from lo to 50 per cent, 
solution) may be added at the time its use 
may be required. A trial package will be 
mailed free of charge. Addresi J. S. Tyree, 
Chemist, Washington, D. C. 

+ 
Schering's "Tonols." 

The wide employment enjoyed by Schering's 
Glycerophosphates shows that in the decade of 
their existence they have established them- 
selves as the most effective form of phosphatic 
medication. Clinical experience abundantly 
proves that they supply an organic, readily 
assimilated phosphorus; that they are true cel- 
lular nutrients, exerting on all the tissues-- 
especially on the osseous and nervous systems 
— a tonic and stimulant effect ; and that they 
are the very best means of administering their 
respective bases (soda, lime, iron, strychnine, 
etc.). 

Glycerophosphate of sodium and combina- 
tions of the glycerophosphates have in the 
past required bulky vehicles (syrups and 
elixirs), which contain such undesirable in- 
gredients as glucf)se and alcohol, arc liable to 
decomposition, and materially enhance the cost 
of the medication. This difliculty is overcome 
by Duotonol, Triotonol, Quartonol and Sex- 
tonol, which prc&,^nt the glycerophosphates in 
a compact and stable form, convenient for 
carriage and administration. 



ADVERTISEMENTS 







PHILADELPHIA ORTHOPAEDIC 

HOSPITAL AND INFIRMARY 

FOR NERVOUS DISEASES 

School of 
MASSAGE AND ELECTRICITY 

The Original Place and 
The Original Method 

Four months' course of instruction in 
Massage, Swedish Movements and Electricity 

Fee $75 for Massage and $25 for Elec- 
tricity. Board not included 
Payment in advance 

Lectures Given Weekly by Members of the 
Medical Staff of the Hospital 

Practice daily under constant supervision 
Certificate Given 

CClasses are formed in October and 
January. CPupils have access to the 
Wards of the Hospital and the numer- 
ous cases referred from the clinics 

For further information address 

SUPERINTENDENT 


The Nauheim 

"D J 1 are given by 
Oa.Lilo means of the 

TRITON 

EFFERVESCENT 

Bath Salts 

The preparation of an artificial Nau- 
heim Bath surcharging the water with 
carbon dioxide by adding to a tub of 
water a package of Triton Salts is 
simple to the last degree. We shall be 
glad to send literature and manual of 
the Nauheim Treatment on request. 

THE TRITON COMPANY 

Schieffelin & Co. 

NEW YORK 
Sole Ivicentees and Sole Assents 








In 

Obstetrical 

Work 



the need for an 
effective tonic 
both before and 
after parturition 
and in the trying 
period of lactation 
is often very urgent 



Gray's Glycerine Tonic Comp. 



not only meets every 
requirement but it can 
be administered without 
a fear as to any untoward 
effect, on either mother 
or child. 

Effective, reliable and %z 



THE PURDUE FREDERBCK CO. 
398 Broadway, New York 




Wtien yoii wrftf Advertisers, plcnso mention Tiiio Tratnkd Nursk. 



68 



THE TRAINED NURSE AND HOSPITAL REVIEW 



This Should Interest You. 

It certainly is of interest to know that a 
very powerful antiseptic, germicide and disin- 
fectant has been discovered which is practi- 
cally free from all danger. The name of the 
product is Chinosol, the exact chemical name 
being potassium oxychinolin sulphonate. 

The eminent German authorities, Beddies 
and Tischer, in the Allg. Med. Centr.-Zeitung, 
state the power of Chinosol in arresting diph- 
theria, cholera, typhoid and saprophytic bac- 
teria to be thirty to fifty times greater than 
carbolic acid. They state, in fact, that the 
bactericidal power of Chinosol is simply 
enormous. 

Prof. Steenhuisen reports Chinosol as being 
far superior to corrosive sublimate or carbolic 
acid. 

Prof. Emerich reports favorable results in 
the treatment of ulcers and infected wounds 
with a Chinosol solution even as weak as i 
to 40,000, and yet over 125 grains of pure 
Chinosol have been administered to a rabbit 
for three consecutive days without any un- 
desirable results whatever. 

+ 
Danger of Soles That Retain Moisture. 

In a recent number of the Ladies' Home 
Journal — in her department, "Pretty Girl 
Questions" — Emma E. Walker, M. D., says : 

"Leather is sometimes treated with glucose 
and barium, so that it absorbs and retains 
moisture to a high degree. A shoe made of 
such leather is never dry, for the natural 
moisture of the foot is retained by the leather, 
which makes a dangerous foot covering." 

These foreign substances are used in the 
process of tanning to add weight to the sole 
leather, which is sold by the pound. Shoes 
made from such leather, as Dr. Emma Walker 
says, are dangerous because of their con- 
stant, dampness. 

In tanning the leather that is used for the 
soles of Red Cross Shoes, none of these 
"weighting" substances are used. Red Cross 
Shoes are from one to three ounces lighter 
than ordinary shoes. 

If you wear Red Cross Shoes, you know 



Wf 



what this freedom from foreign substances 
means. If you do not wear them, write the 
makers, Messrs. Krohn, Fechhcimer & Co., 
for their booklet, "A Lovable Shoe." It shows 
the importance of foot comfort to health and 
shows the latest styles. The Red Cross is 
made in glazed kid, tan and patent leathers. 

+ 
Practical Points from Meinecke & Co. 

Before inserting the stopper in an ice bag 
pull down the bottom of the bag and then in- 
sert the stopper. The bag will contain enough 
air to prevent the top and bottom from 
sticking together. 

To prevent the stopper from sticking in the 
neck of an ice bag place a piece of tissue 
paper around the screw thread on stopper 
before screwing the stopper into the bag. 

By placing an ice bag in an ordinary paper 
bag before applying prevents the patient from 
getting wet from the sweating of the ice bag. 

When buying an ice bag insist upon having 
one with a rubber-covered stopper, as the 
rubber cover prevents the washers fom being 
lost. 

Insist on your dealer selling you a hot water 
bottle having a "Holdfast" Unloseable Stopper, 
so that when you hang the bag up to drain the 
stopper cannot be lost. 

When the bag is drained pull the bag apart 
before inserting the stopper, and enough air 
will enter the bag to k?ep it from sticking 
together. 

Before applyifig a hot water bag to a 
patient put it in an ordinary paper bag; it 
will then retain the heat longer and will not 
burn the patient. 

When giving a patient a drink the glass or 
cup should be half full, so that the patient 
can tilt it more easily. 

The "Simplex" Sick Feeder is the best feed- 
ing cup on the market, as the outer rim 
doesn't touch the patent's nose when he tilts 
the cup. 

When a patient is using a cup while he is 
lying on his back, the back of his neck should 
be supported by a pillow and the back of his 
head free. 



Cafile of Contents 



Page 

Building a Training School Charlotte A. Aikens 71 

The Nursing of People of Moderate Means, from the Viewpoint of 

THE Physician (Continued) Franklin W. Barrows, M.D. 76 

The Open-Air Treatment at a Famous Health Resort, and Some Gen- 
eral Health Directions George F. Brown, Jr. 80 

Infant Feeding (Continued) . Myer Solis- Cohen, A.B., M.D. 85 

Hydro-Therapy at Home 88 

Pneumonia ..••.... Annie E. Hutchinson 89 

The Importance of the Nurse to the Pregnant Woman. ^. P. Reed, M.D. 92 

Extracts from the Journal of a Pupil Nurse (Continued) 95 

The Visiting Nurse — Some Experiences B. B. M. 100 

A New Anesthetic CM. Piatt 103 

The Diet Kitchen Rose R. Grosvenor 105 

Editorially Speaking 108 

In the Nursing World in 

The Editor's Letter-Box 1 18 

Book Reviews 124 

The Hospital Review 128 

New Remedies and Appliances 134 

The Publisher's Desk. . . 142 



IN THE OBSTETRICAL CHAMBER 

not only in caring for the mother, but also for starting 
the little new-comer on the road to healthful cleanliness 

PACKER'S TAR SOAP 

holds undisputed sway among doctors and nurses alike. ^The purity, antiseptic 
blandness and emollient properties of Packer's Tar Soap are too well known to re- 
quire argument. It is dependable-has been for thirty-five years-that's enough. 
PACKER MANUFACTURING COMPANY, - NEW YORK 

Wben you write Adrertisere, please mention Tbb Teaimbd Ndbsb. 



ADVERTISEMENTS 



ADVANCED SPECIALTIES 



ROOM AND HOSPITAL 

.ei]niecK.e (Si Co.'s 
Aseptic OperaLiing Patds 




FOR 



Pat. June 14 and *i, 1904, 

Also patented in 

Great Britain, Germany and France. 



THE 
ONLY 



KELLY 
PADS 




Sbotving bow tb* 
outlet sleeve may 
be turned inside out 
to be cleaned. 

This style pad Is 
made with a (revers- 
ible) closed sleeve, 
which hooks up to the rim in such a 
manner as to catch amnion, blood and 
placenta, which collected In this 
pocket can be transported to the 
bathroom, weighed and Inspected, 
without the use of any other vessel. 



READ WHAT DR. KELLY, THE ORIGINAL INVENTOR 
OF THE " KELLr PAD," SATS OF THEM: 



Baltimore, Md., December 31, 1903. 
MEINECKE & COMPANY: 

Gentlemen :-Sometime ago your new Aseptic Operating Pad was 
received, which Is now used In my operating room with much satis- 
faction. It Is a great Improvement over any other pad that has 
as yet been put upon the market. The absence of crevices, which 
catch dirt and lodge Infection, makes it practically a perfect pad. 

I trust It will be as widely appreciated as It deserves. 



Yours truly, 



lyrZri^r-fA/y^ (a , 



'.re THE 
VERTICAL WALL 

NO CREVICE 
/ UNDER THE S^/ 
INFLATED RtM ^ 



PKICES TO PHYSICIANS 

No. 15 — Open style, Perineal Size, 15 In wide. - $6.00 
No. 2<) — Open styie.Standard Operating Size. 2" In 
No, 24— Open style. Large Operating Size, 24 in 
No. 50— Closed style.with Outlet Sleeve, for Ob- 
stetrical or Surgical Use, 22 in. wide. 
Inflating Bulb supplied with each Pad, complimentary. 
Sent by express, prepaid, upon receipt of priM. 



8.00 
9.00 



9.00 



SECTIONAL VIEW 
WHOLESALE PRICES ALLOWED TO H )3PITALS. 



MEINECKE (SL CO. 



48 CEk. 50 
PARK PI^ACC 



NEW YORK. 



Every Hospital ouperlntenoenl. Principal of Training School or Hotpilal Buyer thot/ld write for Meineclce & Company'* 
complete catalogue, kancnomely illuttrated, thowing theii fuD Una of "Advanced Specialtiet" for Hotpital u<e. 



€I)e CrameJ) Jturse arfb 



VOL. XL. 



NEW YORK, FEBRUARY. 1908 



NO. 2 



Butltiing a Craintns ^cfjool 



CHARLOTTE A. AIKENS. 



''TT^O erect a training school building 
-*■ with modern classrooms, dormi- 
tories and living rooms is a comparative- 
ly easy matter. To build a training school 
is a different and a larger problem. To 
be able to plan and carry to completion 
a modern institution without a misfit, 
blunder, or superfluity in any part, or to 
build one of the great floating palaces 
necessary for ocean transportation, is an 
achievement worthy of the age in which 
we live. Scientific knowledge is neces- 
sary, and accuracy in every detail of 
workmanship can alone lead to success. 
The whole world is ready to give its 
meed of praise to those who undertake 
and carry forward such enterprises. 

But those who undertake this kind of 
building are dealing with inanimate 
things, which can be measured to the 
smallest fraction and shaped according 
to the will of the builder. Those who 
build a hospital training school have to 
deal with living material. They must 
carry on their work subject to influences 
which they can only indirectly control 
They are trying to build what eyes can- 
not see; to develop an ideal that exists 
in the mind ; to shape human character, 
to develop legitimate ambitions; to train 
human hands and hearts and brains to 



the end that the highest and best form 
of service to the sick may be possible. 
This, after all, is, or should be, the great 
aim and object before every training 
school board. Those who build wisely 
and well a hospital training school de- 
serve far greater credit than those who 
plan and direct the construction of a 
twentieth century skyscraper. Their 
task is far more difficult than that of the 
man who builds with stone and w o.l 
and iron. 

The great difficulty with training school 
development in America has been that 
the vast majority of those engaged in 
such work have been working largel}- or 
entirely at random. Things have been 
put into the course here and there, with- 
out any good reason for including them 
in the training process. In many cases 
neither the authorities of the school nor 
the lecturer who was supposed to im- 
part the instruction, could tell what defi- 
nite results they hoped to produce as the 
outcome of a large part of the instruc- 
tion given, and the interests of the sick, 
as well as of the pupils and the institu- 
tion, have suffered as the result of ran- 
dom training. To build a training school 
one must have good material and teach- 
ers who know how to develop it. The 



72 



THE TRAINED NURSE AND HOSPITAL REVIEW 



old idea dies hard that every man (or 
woman) who holds a diploma from a 
medical school in some mysterious way 
becomes possessed of the ability to teach 
nurses. Some of the most capable phy- 
sicians in the practice of medicine have 
shown themselves to be lamentable fail- 
ures when they tried to occupy the teach- 
er's chair. Every nurse can remember 
with gratitude the clear, concise, syste- 
matic, practical teaching received from 
some physician. She knows that some 
of her best lessons were learned under 
his direction and tuition. Years after 
her diploma has been signed she finds 
herself turning over the familiar pages 
of her notebook to refresh her memory 
about certain things. She also remem- 
bers with feelings of weariness and im- 
patience the other kind of teacher who 
talked at random for an hour and a half 
at a stretch about some subject which 
she knew would be of very little if any 
use to her in the real practice of her art. 
Not long since I was told of a course of 
five lectures given last year to the nurses 
of a certain school on "The Ear." Now, 
granting that the ear is an important part 
of the human anatomy, the amount of 
knowledge that a nurse needs to have 
about the ear and how to care for it in 
health and disease could have been cov- 
ered in one, or at most, two practical, 
simple, concise lectures. All these ear 
lectures were given after 8 o'clock at 
night, and tired nurses were obliged to 
sit hour after hour listening to a mass 
of detail about ear operations and treat- 
ment from which they could never hope 
to derive any benefit. "The doctor got 
a good chance to advertise his specialty, 
and incidentally the specialist, and he 
used it to the full," was the comment 
made by the person who related the in- 
stance. In one curriculum thirty-six lec- 



tures on anatomy were scheduled for 
last year, and divided among eleven doc- 
tors. Think of the weary hours the 
nurses of that school must have known 
as the eleven came in. one by one, to lec- 
ture on anatomy. What a miserable farce 
called training it must have been as they 
tried to put together the patchy lectires 
of the eleven I 

It is safe to say that no really succes>- 
ful training school will ever be buiii by 
the use of such methods. Not only the 
subjects to be taught, but the teachers 
who are to teach have in many cases 
been chosen at random, and the result is 
a thing called a "system of training." 
which is well deserving of all the adverse 
criticism it has received from all sorts of 
people. It is high time for a reactionai y 
movement to set in, or any movement, 
which will mean a careful analysis of 
the general situation and the introduc- 
tion of rational common sense metho U. 

The custom already inaugurated in- 
some schools of employing and paying 
two or three physicians to do the nece- 
sary teaching, in addition to that which 
is taken care of by the superintendent 
and her assistants, is one that will accom- 
plish much in getting rid of the super- 
fluities which have gotten into the course 
of study, the rubbish with which nurses 
have been burdened and of which so 
many are complaining. One lecturer 
thinks his specialty is of supreme im- 
portance and insists on putting as much 
as he possibly can of it into the course. 
Another is an enthusiast on another line. 
Number three complains that the other 
two are getting more attention than he, 
and that his specialty has not a fair 
show, and the superintendent of nurses 
wants to place the emphasis some place 
else. Under a plan of paid instructors 
this foolish rivalry will be avoided. The 



THE TRAINED NURSE AND HOSPITAL REVIEW 



73 



sum paid for teaching need not be large, 
but even a small sum gives the hospital 
a control over the training school studies 
and teachers that is impossible under 
present methods, where the teaching is, 
for the most part, committed to unpaid 
volunteer and often wofuUy incom- 
petent teachers. If a physician is paid 
even a small sum to teach, he can be 
called to account if he is wasting time 
by introducing unprofitable topics into 
his lectures. If he doesn't fill the bill 
as a teacher he need not be retained. If 
he is ambitious to excel in that work, 
and satisfactory, he can be carried on 
the teaching staff for years. 

What kind of teaching have we a right 
to expect when we appoint a physician 
to teach a certain subject for no other or 
better reason than that he will be jeal- 
ous if he is not invited? 

A couple of paid instructors in every 
school to whom will be entrusted the 
bulk of the teaching aside from actual 
nursing instruction is an ideal well 
worth striving for in every school, how- 
ever small. Two lessons a week through- 
out nine months of the year, or even 
less than two some weeks, would be 
sufficient to cover a practical course in 
a systematic way, and the cost would 
be so small as not to be burdensome to 
even the smallest hospital. When an 
institution decides to employ a teacher 
of dietetics or massage it raises the 
money to pay them, and there is no rea- 
son why the same should not be true of 
the teaching on other lines. It is simply 
a question of thrashing over the subject, 
pro and con, and deciding to do it. In 
the end it is a real economy. 

If the course were divided into two 
main divisions, which, for convenience, 
might be classified as medical and surgi- 
cal, with the understanding that all the 



important subjects to be taught should 
be assigned to one of these departments, 
a teacher would get, at the beginning, a 
grasp of the whole situation and could 
systematize his knowledge accordingly. 
Fewer and better lectures would be 
given and this would mean a great sav- 
ing of nurses' time. When a class of a 
dozen nurses have to sit for an hour and 
a half listening to a lecture that they 
did not need, which they did not clearly 
take in, and from which they would de- 
rive no benefit if they had, it means a 
clear waste of eighteen hours of nurses' 
time, besides the lecturer's time. Far 
better would it be in the long run to let 
the doctors skip many of the lectures on 
medical subjects and spin off in their 
automobiles and the nurses play tennis 
or indulge in a game of snowballing 
than to shut them in the hospital to carry 
out a senseless program such as is be- 
ing carried out in hundreds of hospitals 
at the present time. 

For the teaching process to take place 
there must be a teacher who knows not 
only the subject matter to be taught, 
but who understands the business of 
teaching it. There must also be pupils 
ready to receive instruction. The at- 
tempt to limit by legislation the supply 
of pupil nurses or to discriminate against 
candidates who have not had a high 
school training has already been de- 
feated in some States since its adop- 
tion, and it is certain to be defeated in 
others, for the simple reason that enough 
high school pupils cannot be obtained 
who desire training, and the ranks in 
the training school must be kept filled. 
The law of demand and supply can 
never be successfully ignored for very 
long. It is more powerful than any 
other law, and influences every line of 
the world's activities. Good legislation 



74 



THE TRAINED NURSE AND HOSPITAL REVIEW 



is a good thing, and foolish legislation 
is a foolish thing, however eminent and 
highminded its promoters may be. There 
is no need for any one to become panic 
stricken because of freak legislation 
along this line, for adjustment is sure 
to follow in response to genuine human 
needs when once those needs are made 
public. 

The term "elevating the standards of 
training" has been so glibly used in re- 
cent years by all classes of people, let- 
tered and unlettered, that it has become 
a veritable by-word, obnoxious to many 
broadminded, far-seeing individuals who 
are able to see underneath the surface. 
There are those who have sense enough 
to see that rushing ahead in a wrong di- 
rection can never be called real progress. 
There are those who believe that when 
it is clearly seen we are not on the best 
road for reaching the desired goal, that 
there is a safer, easier way of getting 
to the point we wish to reach, the wise 
thing is to admit that we have made a 
mistake and "find out where we are at" 
and look for the easiest, surest way to 
get out of the difficulty. 

The task before* hospital authorities 
is to take the raw recruits who have 
announced their desire to learn how to 
care for the sick and teach them how 
to do that one thing. "This one thing I 
do, not forty things I dabble in," is a 
good motto for builders of training 
schools. 

The main question is not what the 
nurse thinks she would like to know, 
not what you, or I, or John Brown, may 
be most interested in, but what the sick 
people and the public need that training 
schools should give them. So long as 
our minds are filled with fads or mere 
notions without reason, so long will our 
present illogical and random methods 



continue. Until we are ready to throw 
aside all prejudice brought about by 
either education, historical reminiscence, 
or unsystematic habits, and study the 
real object, the efficient care of the sick 
and how to provide for it ; so long as 
we are willing to work at producing an 
elaborate, showy, superstructure called 
a "course of study," leaving out of con- 
sideration how much of that study a 
nurse will need to practice the art of 
nursing intelligently, so long will our 
methods excite the ridicule of thought- 
ful people, so long will the number who 
are willing to submit to the cramming 
process and accept the conditions piovo 
inadequate for the real needs of the sici< 
in institutions. 

What kind of nurses do sick people 
in general need? This is above all a 
practical age. People are given to ask- 
ing practical questions. The sick need 
a person who is, first of all, not above 
her business ; who regards the comfort 
and peace of mind of the invalid as of 
paramount importance and is willing to 
exert herself to secure it; who kno\v>^ 
how to intelligently observe his condi- 
tion and minister to his needs. Tl.e 
average invalid does not care a straw 
whether she has spent two years or 
three in reaching this stage of efficiency. 
He is, as a rule, profoundly indifferent 
as to whether she knows anything about 
embryology or the foetal circulation. He 
never thinks of asking if she knows how 
"to apply the flame test for sodium, 
potassium, calcium, strontium, by borax 
bead and Bunsen burner and by groups." 
Even the fact that she has, or has not, 
the right to write R. N. after her name 
fails to impress him forcibly one way or 
the other. He is anxious that his beef- 
steak shall be properly cooked and 
served hot, and in an appetizing man- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



75 



ncr, but her ignorance as to the exact 
manner in which the nutritive elements 
of the beefsteak are to be absorbed by 
his body will not affect in the least his 
appreciation of her services. He wants 
a woman with a kind heart who knows 
how to give him the needed care and 
keep him comfortable, who will not try 
to organize a miniature hospital and de- 
mand three clean towels and a pair of 
clean sheets every day; who will be con- 
siderate of his circumstances, and make 
no unnecessary or excessive demands on 
his pocketbook. 

To supply this kind of nurses is, or 
should be, the main business of the aver- 
age training school. The amount and 
the kind of instruction needed to de- 
velop this type of nurse have never been 
determined. The one thing that has 
seemed to be decided has been the length 
of time required for the making of the 
nurse. Having decided on the length 
of time, we have proceeded to put in 
stuff of all kinds to fill it up, or to jass 
away the time. What would be thought 
of the builder of the modern bui'ding 
who first decided on the height of the 
building and then proceeded to throw in 
one thing and then another to help roach 
the desired height? Is not that practi- 
cally what we are doing to-day, in build- 
ing and developing training schools? 

Whatever other causes are contribu- 
tory to the present embarrassment, 
caused by lack of nurse candidates, we 
must, if we are honest, acknowledge that 
our lack of method, the false standards 



of training that have been created, and 
the long term required for graduation 
are the main causes. In calling a halt 
and getting the business on a rational 
basis the wisdom of many minds will be 
needed. The system is on trial and a 
jury that is unprejudiced, that will 
weigh every point impartially, is as 
surely needed as in any court of justice. 
All over the country people are inquir- 
ing concerning this matter. "How much 
is a hospital responsible for arranging 
that its nurses shall be taught in order 
that they may be able to render efficient 
service to the sick?" is a present day 
question of great importance. 

The American Hospital Association, 
composed as it is of men and women of 
broad experience in hospital work, of 
physicians, laymen and nurses, fully con- 
versant with hospital and nursing needs, 
is the only association of which we have 
any knowledge that is in a position to 
take a broad, unprejudiced view of the 
present situation. This association has 
before it many important hospital prob- 
lems, but none more weighty than study- 
ing out the essentials of nursing, and 
deciding on a minimum curriculum. Al- 
ready plans are being made for the next 
convention, which meets in Toronto in 
September, 1908 — plans that are far- 
reaching in importance. It is hoped that 
the committee appointed to report on 
the progress of training schools will give 
this phase of the training school situa- 
tion in the United States and Canada, 
the emphasis it deserves at this time. 




Cfje JEursing of people of JHolierate 0itma 
:jFrom tije "gTietopoint of ttje ^l)j>6ician 

FRANKLIN W. BABROWS, M. D., BUFFALO, N. Y. 

(Continued from January Number.) 



THERE is, however, another phase 
of the problem — another side, 
which is forced upon our consideration 
because in the minds of some physicians 
it ecli^es every other feature of the 
nursing situation and leaves the nurse 
herself in the midst of a penumbra of 
darkness, minus the halo with which she 
was always crowned in earlier days. I 
refer to the trades-union spirit, or policy 
— in a word, commercialism. 

Says Dr. Lichty, of Rockford, 111.: "I 
do not think that they are taught along 
exalted lines of altruism as physicians 
are. Nursing is not to be their life 
work." Dr. Maude McConnell, of In- 
dianapolis, attributes to some representa- 
tives of the profession "a lack of the 
philanthropic spirit which all nurses are 
supposed to have." Dr. James Tyson, of 
Philadelphia, excuses this obvious defect 
by saying: "Perhaps they have not lieen 
educated to appreciate this highest pur- 
pose of their calling." This lack of al- 
truism is alleged as the cause of union- 
ism — the policy that is invading th* 
ranks of trained nurses all over the land, 
according to our information; the policy 
that keeps a nurse idle for days in her 
room while poor people need her services 
and she needs the modest income that 
they are able and willing to give her. 
This business policy is severely arraigned 
by Dr. Oilman Thompson, of New York, 
a physician who has written much during 
many years for and about nurses. He 



brings against the nurses of New York 
the very same accusation that I myself 
would bring against the union carpenters, 
union paperhangers. union painters, 
etc., of my own city. He says : 

"In no other occupation is one com- 
pelled to pay the same fee for services, 
good, bad or indifferent — $25 for the 
best nurse, capable of managing an entire 
hospital, perhaps, and $25 for the poor- 
est, not capable of managing herself!" 

This is the spirit, also, that discourages 
and ostracises the cheap niirse, whose 
only offense is that she has made a super- 
ficial preparation to do second rate or 
third rate work for sick people who can 
not get first rate nursing, either for love 
or money. The physician deplores the 
fact that the trained nurse will not give 
aifl, comfort or even toleration to the 
woman who enters or proposes to enter 
this inferior line of service. To quot^ 
Dr. Oilman Thompson again: 

"The trained nurse (the over-traine ' 
nurse) monopolizes all hospitals an! 
actively excludes every opportunity for 
the trained attendant to acquire instruc- 
tion." 

In this same spirit. Dr. Cochrane, of 
Albany, writes: 

"Trained nurses (i. e., Registerel 
Nurses) cannot be expected to work for 
less than the regular recognized fee, in 
view of the fact that they have spent 
three years in hospital training and are 
laborers worthy of their hire. On the 
other hand, they should not oppose the 
entrance into the field of domestic nurses 
with an abbreviated training, who are 
willing, and justly so, to work for small- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



77 



er wages among the class of patients de- 
scribed truthfully as 'limited means' pa- 
tients." 

Pardon me if I take the time to state 
this issue once more, clearly and finally, 
before passing to the last topic of this 
paper. The mere fact that there are not 
enough hospitals or trained nurses to care 
for the sick man of moderate means 
certainly does not deliver the sick man 
from his dilemma. He is bound to have 
somebody to nurse him; and that some- 
body, if she has the faintest spark of 
progressiveness, will seek the advice and 
instruction of some one who knows more 
than she knows — in other words, she will 
become partly trained for her work. In 
the very nature of her calling she is by 
no means the rival or competitor of the 
trained nurse. The patient needs her. 
The physician must work with her. Shall 
the trained nurse encourage her? Shall 
the trained nurse teach her and assist 
her to make the most of her slender re- 
sources? Or shall the trained nurse 
ignore her altogether and thus ignore 
that large class of society dependent 
upon her? 

The physicians have suggested many 
expedients, in answer to question 5, for 
improving the character of the nursing 
service now rendered to the patient of 
moderate means. For convenience in dis- 
cussing these forty "most feasible" 
plans, we shall have to group them un- 
der a few general headings. 

I. Education. By thorough teaching 
of physiology and hygiene in our public 
schools, and by lectures and popular ar- 
ticles in the newspapers and other period- 
icals, the young and old may be taught 
many things that will serve a good pur- 
pose in making the lot of some sick 
friend safer and more tolerable. Educa- 
tion will also create new bonds of sym- 



pathy between the sick and those who 
have the care of him, and will steadily 
increase the demand for competent 
nurses. According to Dr. Clements, of 
Buffalo, the family physician should take 
a part in this educational campaign by 
teaching his families, as best he may, the 
difference between skilled and unskilled 
nursing and by insisting at all times on 
the necessity of getting the best possible 
nurse for his patients. Such faithfulness 
would help to redeem him from the criti- 
cism made by Dr. Lytle, of Buffalo, who 
says that the physician is persistently dis- 
loyal to the trained nurse in that he too 
frequently expects her to reduce her 
charges, or to give place entirely to a 
cheaper nurse. 

2. Hospital Facilities. These should 
be greatly increased and more attention 
should be paid to the needs of the patient 
of moderate means. Dr. Lichty, of Rock- 
ford, 111., advocates a system of "com- 
munity" hospitals, to be established in 
villages throughout the country for the 
benefit of those who are remote from 
large cities. 

3. The Visiting Nurse. Organizations 
which supply trained nurses to visit the 
sick and care for them gratuitously, or 
at a nominal charge, are in great favor 
with the physicians ; they are warmly ad- 
vocated as a feasible solution of this 
problem, by Dr. Snyder, of Toledo; Dr. 
Scott, of Niagara Falls; Dr. Pitts, of 
Provivlencc; Dr. Smith, of Bloomington, 
111. ; Dr. Clements, of Buffalo, and 
others. Dr. Gustin Welch, of Niagara 
Falls, is in favor of some such plan as 
that followed with great success by the 
Victorian Order of Nurses in Canada. 
One reason why the visiting nurse com- 
mends herself to the physician is because 
she not only attends to the wants of the 



78 



THE TRAINED NURSE AND HOSPITAL REVIEW 



sick, but serves as a most efficient teacher 
of hygiene and other useful subjects, at 
a time and place in which such instruc- 
tion is most eagerly accepted. 

4. Special Funds for the Endowment 
of Nursing Service. The John Crerar 
Fund, in Chicago, assists the patient in 
paying for a trained nurse. For example, 
a patient who is able to pay the nurse 
only $10 a week may draw $15 per week 
from the fund to make up the deficiency 
in the nurse's pay. This endowment is 
commended by our correspondents in 
Chicago and is well worthy of imitation 
by the philanthropists of other cities. 

5. Low-priced Nurses and Attendants. 
Dr. James Tyson, of Philadelphia, writes : 

"Either the trained nurse must be will- 
ing, as physicians are, to take such cases 
at less than their usual fees, or they must 
consent that there shall be a class of 
nurses not so well trained as their more 
favored sisters, who are willing for this 
reason to work for smaller compensa- 
tion." 

A^ to who shall constitute this class, 
and how and where they shall receive 
their training, there is a large variety of 
suggestions. Several physicians favor 
the sending out of pupil nurses, under 
supervision of competent instructors. Dr. 
George Roberts, of Buffalo, would have 
classes of nursing conducted by the 
churches, for the purpose of instructing 
attendants for the sick. Dr. Snyder, of 
Toledo, favors 

"a course of nursing for girls, lasting 
two afternoons a week for six weeks, as 
we do cooking and sewing in our manual 
training course ; this to be supplemented 
by the supervision of a visiting nurse, 
such as our visiting nurse society gives 
the poor, and especially the tubercular 
poor, of this city." 

The methods of the Albany Guild for 
the Care of the Sick, and the Eastern 
New York Training School for Domestic 



Nurses involve more time and work, but 
they are abundantly justified by the re- 
sults. 

Dr. Gilman Thompson, of New York, 
would have the attendants prepared for 
their work by a course of training in the 
hospital wards under supervision of 
trained nurses. As he himself states it: 

"Hospitals should admit for brief 
periods of study (say six months) a 
class of trained attendants who should 
be exercised in the care of ordinary cases 
of illness not involving special technical 
skill, or extended experience, and who 
could in serious cases aid the trained 
nurse in the work and during convales- 
cence supplant her at less expense to the 
patient."- 

There is no one plan that is so gener- 
ally contemplated for the solution of our 
problem as this plan for providing trained 
assistants. There is no doubt that it will 
prevail over all other methods of caring 
for the sick of limited means, in many of 
our cities. It should be a matter of the 
greatest concern for nurses and physi- 
cians to see that the attendants thus pro- 
vided shall be the very best that the exi- 
gencies of the times will admit. To this 
end, the physician asks the nurse not to 
scorn this movement, but to lend a hand. 

6. Case Nursing, or Hourly Nursing. 
This method of caring for the patient of 
moderate means commends itself to us 
all for the reason that it offers the trained 
nurse an opportunity to help these people 
without impoverishing herself or detract- 
ing from the first-class quality of her 
service. It opens the way, also, for a 
friendly and helpful association, on the 
same case, of the trained nurse and the 
assistant nurse. Case nursing is highly 
endorsed by Dr. A. T. Bristow, from 
whose letter I will quote. He says: 

"Few nurses, so far as I know, will 
give a patient a half hour's attention for 
less than $1.50. At this price there is 



THE TRAINED NURSE AND HOSPITAL REVIEW 



79 



little economy for the patient. The fees 
for case nursing ought to be brought to a 
point where the nurse could earn as 
much as she can earn when employed 
by the week, and no more; and it is 
just here that she can and should be will- 
ing to adapt her fees to her patient's 
means, as do the doctors. No nurse can 
afford to give her entire time to a case 
for much less than the standard fee. She 
could, however, shade her rates to one 
or two patients out of say six attended 
per day. An economical way of utilizing 
the time of nurses while waiting for 
weekly cases would be for the different 
homes to inaugurate a system of case 
nursing by waiting nurses, no one nurse 
doing all the case nursing, but the home 
taking charge of this service, the returns 
to be pooled and divided. Thus no nurse 
would be continuously away from the 
home for a long period, and so risk los- 
ing a weekly case." 

Dr. Maude McConnell, of Indian- 
apolis, suggests a similar plan, and re- 
minds us that any nurses registry may 
be organized in such a way that the nurse 
at the bottom of the list will always be 
available for work at reduced rates, until 
she receives a more profitable call, and 
another nurse carries forward the low 
rate case. 

In closing this review we observe that 
all the various remedies which the doc- 
tors have prescribed to relieve this eco- 
nomic disorder are calculated to make 
more work for the philanthropist, because 
without capital in the form of investment 
and endowment, such things as hospitals, 
Crerar funds, visiting nurse societies and 



the like will have to wait. We cannot 
ask an association of nurses to capitalize 
any such institution, but we do ask for 
their moral support and co-operation in 
every enterprise that promises to reduce 
the sum of human peril and suffering in- 
cident to disease. 

The nursing profession to-day seems 
extraordinarily weak in numbers when 
we consider the countless opportunities 
within its grasp, but it is strong, and 
stronger than ever, in the position that 
it occupies among the economic and 
social forces of our times. The medical 
profession believes in the trained nurse, 
and however disloyal — unchivalrous — 
certain physicians may seem, you may be 
assured that they have no desire to sup- 
plant the well-trained nurse by any sort 
of assistant or substitute whatsoever. 
Only when the most stringent economic 
conditions seem to make it imperative 
will the loyal doctor consent to this sort 
of substitution. Since the trained nurses 
are failing numerically to meet the grow- 
ing demands upon them, it seems but 
right that they exercise a jealous interest 
in those forms of service that are to 
some extent taking their own place and 
usurping their function. In helping 
these various agencies and co-operating 
with them, the nurse has a fine field for 
dignified and fruitful work. The nurse 
holds the key to the situation. Will she 
open or lock the door? 



Cf)e ©pen 3iir Creatment at a jfamoufi J^ealtl) 
l^efiiort^ anti ^ome (general f^ealt!) ©ireetionfi 



GEORGE F. BROWN, JR. 



DURING a winter's sojourn in Sara- 
nac Lake, the noted resort in the 
Adirondacks for those afflicted with 
disease of the throat or lungs, the over- 
worked denizen of the city, victim per- 
haps of the constant pressure of this 
commercial age, fallen by the wayside 
in the mad rush to acquire wealth or 
"barely make ends meet." is led back to 
the simple life, and to the ways of health 
that had become a past memory in the 
course of the conventional business and 
social life of the period. 

Chief among the elements relied on 
to build up the weakened body is fresh 
air, the pure, dry air of the mountains, 
that comes laden with a healing balm 
from the great forests of pine and bal- 
sam of the North Woods. For eight 
long hours every day. broken by the 
hour of the midday meal, the patient 
who is trying to coax back health and 
reinvigorate the broken-down lung, sits 
out in steamer chair, wrapped up in fur 
coat and blankets, the feet protected by 
felt boots or moccasins. This is known 
as "taking the cure." On the porches of 
many of the cottages can be seen health- 
seekers, from morning till night, bravely 
and faithfully seeking to regain health 
through nature's remedy, fresh air. With 
chair thrown away back, some neither 
attempt to thijik nor to evince any inter- 
est in the surroundings, but stare blank- 
ly into the sky and simply vegetate, 
knowing that the pure, icy air is staying 
the ravages of the deadly germ. Others, 
raised to a sitting posture, pass the long 



hours pleasantly, and often profitably, 
reading, even when it is most bitterly 
cold. Then some become so accustomed 
to the freezing cold of this Northland, 
that, in gloves with the fingers half cut 
oflF, they write with apparently as much 
ease as indoors. Cheerful, but quiet 
conversation and harmless banter fill in 
the time when there is little inclination 
to exercise the mind seriously. Even in 
the evening, after supper, some of the 
most persistent, in their eagerness to 
"chase the cure," sit out for an hour or 
more. 

Though pure air is the chief element 
in effecting a cure, it is not the only one. 
The health-seeker is urged to eat an 
abundance of wholesome food, all that 
can be assimilated, forcing himself to 
eat even when there is no inclination. 
The diet includes roast meats, as beef, 
mutton, lamb, chicken, turkey and broiled 
steak and lamb and mutton chops. Pork 
and fried meats are not desirable. Vege- 
tables fresh, when available, are an im- 
portant item in the menu. Fruit is 
regularly provided for breakfast, or- 
anges, grape fruit, apples, bananas and 
grapes. Nuts of various kinds are nu- 
tritious, and, with ice cream, often serve 
to mark the Sunday dinner as distinct. 
Pie and pudding are desserts allowable, 
but pastry of all kinds is of little value, 
and in a menu properly arranged is of 
little importance. On the other hand, 
jellies and custards are tasty and will aid 
rather than retard digestion. But to the 
health-seeker the distinguishing feature 



\ 



THE TRAINED NURSE AND HOSPITAL REVIEW 



81 



of the diet is the milk and raw eggs. It 
is essential that the milk be rich in cream 
and the eggs fresh. Three times a day 
lunches of raw eggs and milk are served, 
between breakfast and dinner, in the 
afternoon, and after the evening meal. 
The patient does not have to leave his 
chair, an attendant takes the lunch to 
him on the porch. The eggs and the 
milk maybe taken separately, or the eggs 
may be beaten up with the milk, accord- 
ing to the patient's taste. If taken alone, 



at least one with each lunch, so that six 
glasses of milk daily is a good average. 
In this case also the quantity may vary 
with individuals from eight to ten 
glasses, and even twelve glasses. When 
this extra diet is used in such large 
quantities it is advisable to beat the eggs 
up with the milk, adding a little lime 
water and sugar, and then serve two or 
three glasses at a time from a pitcher. 

Rest is the third element of the open 
air treatment. At first the patient is in 



7- 




k 




m.A 




L 








: 

L 




3 




1 


K i 


1 






i 


1 


i 



TAKING THE CURE AT SARANAC LAKE. 



the egg is dropped into a glass without 
breaking the yolk, and swallowed down 
as a liquid. To some, raw eggs are dis- 
agreeable, so a little salt or lemon juice 
added makes them more palatable. The 
quantity of this egg and milk diet varies, 
l'>om three to six eggs a day are usu- 
ally taken; sometimes as many as eight, 
and rarely, ten or twelve. A glass of 
milk is provided with each mea,l, and 



his chair all day long, except at meal 
hours. He is instructed to retire at 9 
o'clock, not later than 9 130. During the 
night all windows in the sleeping apart- 
ment must be wide open, so that the air 
of the room may be constantly changeJ 
and thereby kept pure. A current of 
fresh air should be passing before the 
nostrils at all times. When the night 
promises to be bitterly cbld, the experi- 



82 



THE TRAINED NURSE AND HOSPITAL REVIEW 



enced health-seeker will, before crawling 
into bed, set his water pitcher outside 
the door, in the corridor. If this pre- 
caution is neglected, he knows he may 
expect to find a block of ice and a broken 
pitcher in the bowl next morning. He 
has also learned that it is wise to do the 
same with his ink bottle and his medi- 
cines that contain no oil. Occasionally 
a topic of conversation is afforded at the 
breakfast table when some one appears 
announcing that his ear or the tip of his 
nose was frozen during the night. Some 
brave and daring and enthusiastic ones 
strive to get as near to nature as possible 
and elect to sleep out on covered 
porches, protected by Japanese curtains 
from rain and snow. Of course, every 
measure of protection is taken to insure 
warmth in bed. Double mattresses are 
often necessary for those who sleep out 
of doors. Woolen night garments, 
sweaters, robes and bed slippers, some 
or all, are used, and many sleep between 
blankets. 'With a liberal supply of quilts 
and blankets, one need not fear a tem- 
perature of forty degrees below zero In 
the "wee small hours" of the morning. 
Those sleeping out often wear woolen 
helmets, with openings only for the cyej 
and nostrils. Ten hours is supposed to 
be the period of rest in bed; nine, at 
least. The bell for rising is rung at 7 
in the morning. An hour or so before 
an attendant enters the room, to close 
the windows and open the register, or 
turn on the steam, so that the room 
shall be warm when it is time to dress. 
Breakfast is served at 8. Then at 9 
the porch is sought, to continue the 
brave fight to regain health. A welcome 
break comes at i o'clock, for dinner; 
and again at 6. for supper, when, except 
for the most persistent the day's "work" 
is done. 



Thus, in the open air treatment, three 
factors are relied on to bring about a 
cure, or effect improvement. These are 
pure air, wholesome food in abundance, 
and rest. The pure air curtails the ac- 
tivity of the disease when nourishing 
food is supplied so as to build up the 
body and provide healthy tissue which 
the germ cannot successfully attack, and 
when the whole wearied system is afford- 
ed a complete rest so that nature can 
repair the waste already created, unim- 
peded by the waste necessarily incident 
to bodily activity. 

The records of sanatoria in different 
parts of the country bear convincing tes- 
timony to the success of this method of 
treatment, in the restoration to health 
and usefulness of very many who have 
been treated, and in the marked improve- 
ment in every case cared for where the 
disease was not too far advanced. The 
fight is a weary one, a trying one, an 1 
the patient's watchwords must be hope 
and courage. Six months is the period 
commonly considered necessary for an 
"apparent" cure in- incipient cases ; longer, 
of course, in advanced cases. An "ap- 
parent" cure may be considered perma- 
nent if there is no relapse for two years. 
Should tuberculosis again appear in the 
case of a permanent cure it is due to a 
new infection. This is sanatorium 
teaching. 

The period of rest and withdrawal 
from participation in the usual activi- 
ties of daily life need not be devoid of 
brightness and enjoyment. There are 
pleasant acquaintances to be made. 
Cheerful, intellectual, helpful conversa- 
tion makes the long hours seem shorter. 
Reading for pleasure and for profit 
keeps the mind occupied and banishes 
care and worry. Often the letters home 
and to friends are written out in the 



THE TRAINED NURSE AND HOSPITAL REVIEW 



83 



chair, and troubles and sorrows are for- 
gotten as daily experiences and the most 
trivial occurrences are related and per- 
haps tender solicitude expressed in warn- 
ing against the breaking of the laws of 
health by loved home folks, and exhorta- 
tion to turn towards the simple life. In 
many cases, after three months, the pa- 
tient is allowed to walk an hour morning 
and afternoon. When the temperature 



in games of cards or chess or checkers 
on the porch, and in short tramps 
through the woods or to nearby points 
of interest, the "cure is chased" uncon- 
sciously because of the enthusiasm which 
exhilarates the mind and drives off 
trouble and care. Driving is one of the 
most favored forms of exercise. In- 
deed, one hour of driving is said to be 
equivalent to two hours in the chair in 




GROUP OF HEALTH SEEKERS AT SARANAC LAKE. 



has been normal (98.6) continuously for 
from forty to sixty days, confinement to 
the chair is not absolutely necessary 
throughout the entire day. But the pa- 
tient must be out of doors all the time, 
and must, under no circumstances, do 
anything that will tire him. This stage 
of improvement reached, there can be 
social gatherings in the evening, with 
music, recitations, card playing and other 
games, but no dancing, and out of doors, 
in using the camera, at target shooting. 



benefit derived, for those who have the 
strength to indulge in it. 

Many attending to daily duties do not 
enjoy real good health, and yet the con- 
dition is not so serious as to make a trip 
to a health resort necessary. For most 
of these relaxation from overexertion 
in business or in social affairs, or both, 
coupled with care as to diet and daily 
exercise in the open air, will restore the 
system to its normally healthy state. In 
this connection the following list of some 



84 



THE TRAINED NURSE AND HOSPITAL REVIEW 



general health directions is recommended 
for daily observance. If these are faith- 
fully heeded there will be imparted to 
the body a luxurious feeling of cleanli- 
ness and vigor. The careful observer of 
them, if free from disease, will have 
little reason for not being always in 
physical condition to perform his duties 
and bear his responsibilities in business, 
social and civic life. 

SOME GENERAL HEALTH DIRECTIONS. 

1. Food — Plain, wholesome, nourish- 
ing. Masticate thoroughly. 

2. Rest — lo p. m. to 6 a. m. One or 
two hours in the afternoon if necessary. 

3. Fresh Air — Living rooms, school 
rooms, bed rooms well ventilated. A 
current of fresh air must be passing con- 
stantly before the nostrils while asleep. 

4. Deep Breathing — Daily, moderate 
exercises. 

5. Calisthenics — Daily, moderate ex- 
ercises. 

6. Bathing — Sponge the body daily, on 
arising, with cold water. One warm 
bath a week. If too rigoroiJ« in cold 
weather, rub thoroughly with rough 
towels the whoJe body every morning. 

7. Throat, mouth, teeth, (i) Gargle 
throat every morning before breakfast, 
and every evening before retiring, with 
cold water. (2) Cleanse the mouth 



every morning before and after break- 
fast, after lunch if possible, and before 
retiring, with cold water. (3) Brush the 
teeth before and after breakfast, after 
lunch if possible, and before retiring. 

8. Drinking Cold Water — Drink a 
glass slowly before breakfast after per- 
forming the operations under 7, several 
times between meals, and after supper 
after performing the operations under 
7, and just before retiring. Take plenty 
of water when feverish. 

9. Do Not Overwork — Work up only 
to your usual capacity, and take regular 
rest. If compelled to undergo extra 
strain, take an extra amount of rest to 
balance. 

10. Raw Eggs and Milk — One to 
three eggs a day, a glass of milk after 
each meal and one in the afternoon. The 
eggs may be beaten up with the iiiilk 
taken after meals. 

11. No Extra Clothing for Throat and 
Chest — Do not bundle up the throat with 
furs or m uf^ r except in a blinding snow 

^stonn or fierce, cutting wind. Use no 
extra covering for the chest, no chest 
protector, except when afflicted with a 
severe cold on the chest. 

12. Cold Water for Throat and Neck 
— Bathe neck and throat with cold water 
in the morning and before retiring, down 
to the collar l>onc. 




WARDS AND OPERATING ROOM, POST HOSPITAL, CAMP COLUMBIA, CUBA. 



f nfant jfecDins 



MYBK SOWS-COHEN, A.B., M.D. 



(Continued.) 



Selection and Care of Bottles and 
Nipples. — (Continued.) 

nr^ HE nipples, of which there ought to 
■*■ be at least two, should be conical 
in shape and made of rubber, preferably 
black. The hole should be of such a 
size that when the bottle is inverted the 
milk drops easily from it, but does not 
run too fast or in a stream. 

That form of nipple which is attached 
to the bottle by a long rubber or glass 
tube must never be used, as it is im- 
possible to keep the tube clean. 

Before being used the nipple should 
be dipped for a moment in hot water. 

Immediately after nursing, the nipple 
should be removed from the bottle, 
scrubbed thoroughly with a soft bristle 
brush at first outside and. then, being 
inverted, inside as well. It should then 
be placed in a solution containing a 
tablespoonful of boracic acid to a pint 
of water and kept there until used again. 
Once a day all the nipples should be 
boiled for five minutes in water con- 
taining a little table salt, the addition of 
which prevents the rubber from becom- 
ing soft. 

Percentage Feeding. 

In modifying cow's milk to make it 
suitable for the individual infant, the 
physician bears in mind the percent- 
ages of the different ingredients he thinks 
the baby requires. Thus, he may order 
a mixture containing 3 per cent fat, 2 
per cent proteid and 7 per cent sugar. 
This is known as percentage feeding. 
While he may give the formula in ounces 
of milk, cream and sugar, he has calcu- 



lated the amounts of fat, proteid and 
sugar contained in the mixture. In this 
way he knows exactly what the child is 
getting, and is enabled to vary the pro- 
portion of the different ingredients in 
accordance with the child's needs. 

The method of percentage feeding is 
plain. Say, for example, it is desired to 
obtain with cow's milk a mixture re- 
sembling human milk. As cow's milk 
contains about twice the amount of pro- 
teid in human milk, by diluting the milk 
one-half we lower the proteid content 
one-half. But this at the same time 
dilutes the fats, which are the same in 
cow's and human milk. Consequently the 
fat must be raised to the proper percent- 
age by the addition of cream. The per- 
centage of sugar, which is also reduced 
by the dilution, is brought to the normal 
by supplying extra sugar. The character 
of the proteid may also be modified by 
the addition of gruel, lime-water, sodium 
bicarbonate, or sodium citrate, or by 
using whey or buttermilk instead of plain 
milk. 

Various methods have been devised 
for calculating the proper amounts of 
milk, cream, sugar and water to take in 
making up milk mixtures containing dif- 
ferent percentages. 

But first of all it is of the utmost im- 
portance to know the exact percentages 
of fat and proteid in the milk and cream 
that are used ; otherwise modification 
would be done merely by gucs.swork. 

Materials Used in Modifying Cow's 
Milk. — Cream is that portion of the milk 
containing most of the fat and a slight 
percentage of proteid and sugar, slightly 
lower than that of whole milk. It rises 



86 



THE TRAINED NURSE AND HOSPITAL REVIEW 



to the top and is skimmed off (gravity 
cream), or is separated in a centrifuge 
(centrifugal cream). The exact per- 
centage of fats contained must be known. 
Cream is suppHed to the market contain- 
ing 12, 1 6, 20 per cent of fats. 

After a quart bottle of milk contain- 
ing 4 per cent fat has stood for six hours, 
the upper 4 oz. will be a 20 per cent 
cream, and the upper 8 oz. a 10 per cent 
cream. After standing eight hours, it 
will yield a cream of 16 per cent in the 
upper six ozs., 12 per cent in the upper 
8 ozs., and 10 per cent in the upper 11 
ozs. 

The cream may be removed by Cha- 
pin's or Gilting's dipper. 

Top milk is the upper portion of milk 
in a quart bottle. It may be removed by 
an ounce dipper devised for the purpose 
by Dr. Chapin, or by the one devised by 
Dr. Gilting. When milk has been bottled 
for four hours, the cream will have risen, 
and all fat will be present in the upper 
portion. Each layer will then contain a 
definite percentage of fat. 

Nine ounce top milk is the upper nine 
ounces in a quart bottle of milk and con- 
tains 12 per cent fat. 

Sixteen-ounce top milk is the upper 
sixteen ounces (one pint), of a quart 
bottle of milk and contains 8 per cent 
fat. 

Milk may be used in a number of 
forms, each containing 3'/2 per cent of 
proteid, but diflFering in the amount of 
fat contained. 

Whole milk contains 4 per cent of fat. 

Separated milk is milk from which the 
fat has been partially or wholly removed, 
either by the centrifuge or by gravity. 

Fat-free milk is a separatei! milk that 
contains practically no fat. 

The lowest 8 oz. of a quart jar of milk 
which has set eight or more Icurs is 
practically fat- free milk. It may be 



syphoned off by means of a piece of bent 
glass tubing to which is attached a small 
piece of rubber tubing with an ordinary 
clamp. The syphon is filled with hot 
water and clamped before being intro- 
duced into the bottle. 

Laboratory milk is prepared in a la- 
boratory so as to have the milk contain 
the exact percentages of the different in- 
gredients called for by the physician's 
prescription. It is produced by first sep- 
arating the milk into cream of known fat 
percentage and fat- free milk, and then 
recombining them in the desired propor- 
tions. 

JJliey is milk from which most of the 
fat and all, or nearly all. of the casein 
have been removed. It contains all the 
sugar, water and albumen. 

It is best made in the following man- 
ner : For each pint of whey needed take 
one quart of fresh milk, preferably fat- 
free milk. Add two teaspoonfuls of es- 
sence of pepsin, or liquid rennet, or a 
junket tablet dissolved in two tablespoon- 
fuls of cold water. Warm the milk slow- 
ly to blood heat (100" F.), and keep it at 
that temperature until thoroughly ctir- 
dled. Then beat up the curd well with a 
fork and keep warm for ten or fifteen 
minutes until the curds have shrunk con- 
siderably. The fluid that remains is whey. 
Strain it through two thicknesses of boiled 
cheesecloth and cool it slowly to a 
temperature of 50' F., and keep it on ice 
until needed. If it is to be mixed with 
cream or milk it must first be heated to 
150' F. (no higher) in order to kill the 
rennet and prevent it curdling the casein 
in the added cream and milk. Whey con- 
tains no fat and about i per cent of pro- 
teid. 

Buttermilk is sour milk from which 
butter has been removed by churning. It 
contains from 3^ to i per cent of fat 
^nd about 3 per cent of proteid. It 



THE TRAINED NURSE AND HOSPITAL REVIEW 



87 



should be used within twenty-four hours 
after being made. It may be made at the 
patient's home or in a hospital as fol- 
lows: Pour a quart of fresh milk into 
a sterile pitcher and tie a sterile towel 
over the top to keep out the dust. Allow 
it to stand for twenty- four hours at 
ordinary room temperature and then 
skim off the cream. Place this sour milk 
in a small glass churn of one-quart ca- 
pacity and churn for fifteen minutes. Re- 
move and place on ice. 

Recently there has been placed on the 
market compressed tablets, called "lac- 
tone,'' containing a pure culture of the 
lactic acid bacillus, which are used in the 
preparation of buttermilk. When they 
are employed no churning is required. 
Before the pitcher is covered a pinch of 
salt and one "lactone" tablet which has 
previously been pulverized are added to 
the milk, the mixture being stirred well. 

Milk Sugar is sugar obtained from 
cow's milk, and is known chemically as 
lactose. Three level tablespoon fuls of it 
equal one ounce. A pure preparation 
must be used. A solution of sugar-water 
is usually prepared by dissolving the 
quantity of milk-sugar desired in boiling 
water. If it contain impurities the solu- 
tion must be filtered through absorbent 
cotton before being used. The sugar- 
water should be prepared fresh every day 
in the Summer time, and every second 
day in Winter. 



Cane-Sugar is familiar as common 
granulated sugar. It is made from sugar 
cane, beets, carrots and the sap of the 
maple tree. Two level tablespoonfuls of 
granulated sugar equal one ounce. It 
should be remembered that all sugar .so- 
lutions spoil when kept too long, espe- 
cially in Summer. 

Lime-Water may be obtained at a 
drug store, or it may be prepared at 
home as follows: Get an ounce or so 
of lime at any grocery store. Pour on 
it a pint of water, stir thoroughly, and 
allow it to slake. When this process is 
completed and the undissolved lime has 
settled, pour off the clear liquid at the 
top, which will contain any potassium or 
sodium and other soluble impurities that 
may have been present in the lime. Re- 
peat this once or twice and the lime will 
be left quite pure. Place the lime in a 
large bottle or quart fruit jar and fill the 
bottle with distilled water and cork it. 
When the lime has been settled so that 
the water above it is quite clear, this 
lime water is ready for use and if desired 
may be poured off into any convenient 
bottle. Always have some undissolved 
lime at the bottom of the jar. As fast 
as the lime water is used more distilled 
water must be added to take its place. 
This may be kept up as long as any lime 
remains undissolved, but it is well to 
use a new piece of lime every two or 
three months. 



{To be continued.) 




?|pl»ro::Ci)erapp at fl^ome 



TJ YDRO-THERAPY, when proper- 
-*- -^ ly applied, is invaluable to the 
nurse who contemplates caring for inva- 
lids, mental cases, or rheumatism. 

We all know how imperative elimina- 
tion is, in those cases. So a few words 
on this subject may not come amiss. I 
will try to tell how to give a sweat bath 
at home. We will take for granted a 
bath-tub, and hot and cold running water. 
A good nurse will always have at hand 
all of the articles she will need in order 
to do anything, so we will start with a 
list of the articles to be called for, in 
order to give a sweat bath at home. We 
need a blanket, a sheet, a towel, three 
wash cloths, a bath mat, soap, four 
pounds of sal soda, a quart of hot lemon- 
ade, and a pan of ice-water. The sheet 
will be hung on the radiator, or in front 
of the stove or register, and now we are 
ready for business; the temperature of 
the room is at least 98 degrees, then take 
the soda and place in the tub and start 
the hot water running. This will help to 
heat the room up, too, as well as dissolv- 
ing the soda. Put your towel at the head 
of the tub and you will avoid that dis- 
agreeable chill one gets on resting on the 
cold enamel. Next cool the water to a 
temperature of about 100, taking care 
to have enough water to cover the pa- 
tient. Put your patient in the tub and 
cover both patient and tub with the 
blanket, being careful to distribute it so 
as it does not dip into the tub. Now give 
your patient a glass of lemonade, and 
repeat at intervals of about five minutes 



until the whole quantity is given. By this 
time the patient should commence to 
sweat, and it is time to keep the head 
cool. This is done by wringing a wash- 
cloth out of ice-water, and wiping the face 
then fold the doth cornerwise and place 
firmly and neatly without "slopping" ; 
on the forehead, also one around the 
neck; wipe the face and change the 
cloths frequently, but do not remove the 
one from the forehead until you have 
another ready to apply. When your pa- 
tient has had a good sweat, give a good 
soap rub, but do not rinse off the soda 
water; put the bath mat down and let 
your patient step out, then (before the 
patient stands up it is well to take the 
towel from the head of the tub and let her 
stand on it, as the soda makes the water 
extremely slippery) wrap the sheet 
around her, using the length of the sheet 
around the neck; let the hemmed sides 
overlap each other in front, and in this 
way your patient will be completely cov- 
ered. Now dry her by rubbing briskly, 
taking the arms first, then the lower 
limbs, and then the back and front; then 
take hold of the upper corners of the 
sheet and fan until quite dry. Now drop 
the sheet, cover the patient with the 
blanket and put her to bed and give her 
an oil rub, to prevent her taking cold. 
You will find this treatment excellent in 
inflammatory rheumatism ; the soda coun- 
teracts the uric acid, and the heat relieves 
the pain. While the patient is in the tub 
keep adding hot water frequently, as it 
soon cools off. 




pneumonia 



ANNIE E. HUTCHINSON. 



A NURSE entering upon a case of 
pneumonia has special need to 
be in good physical condition, as such a 
case always demands constant vigilance 
and frequently entails great strain. The 
nurse is, of course, to be guided by the 
orders of the medical attendant, but 
pneumonia is a disease where sudden 
emergencies are liable to occur, and the 
nurse should know enough about the 
disease to understand the special dangers 
that threaten the patient and be able to 
recognize the symptoms that manifest 
their approach. 

Pneumonia assumes various types and 
sometimes occurs in epidemics. It may 
affect one or both lungs. The right lung 
is more often attacked than the left. 
Pneumonia or pneumonitis — commonly 
termed inflammation of lungs — is one of 
the most common and serious of the 
pulmonary affections. While it is usu- 
ally designated as an inflammation, cer- 
tain recognized authorities tell us that 
the term is not strictly correct, that is, 
in the sense in which we understand in- 
flammation when applied to other organs, 
that, in fact, the inflammatory process 
in pneumonia differs essentially from the 
process in other structures. In ordinary 
inflammation as extensive as pneumonia 
there occur certain local changes — de- 
struction of tissue, indurations, etc. — 
which are absent in pneumonia, for after 
the air cells are emptied of the effused 
material they are in a practically normal 
condition and ready to resume their 
function. The theory that pneumonia 
is really due to the action of germs seems 
to be now pretty generally favored. As 
one medical authority has put it, "in- 



stead of an inflammation of the lung 
tissue, we have essentially a process of 
germ culture going on in the air cells." 
The theory advanced is that a specific 
germ in some manner — most probably 
through the air passages — finds its way 
into an air cell and therein excites an 
irritation in the cell walls, which causes 
an exudation from the capillaries of the 
functional blood supply, and this effused 
material serving as a suitable medium 
for the development and multiplication 
of the germs, they rapidly increase and 
cell after cell, and lobule after lobule, is 
invaded and filled up until a greater or 
less extent of the lung becomes complete- 
ly consoJidated. Throughout this proc- 
ess the cell wall continues to be nour- 
ished by the vessels of the nutrient blood 
supply and thus the integrity of the tis- 
sues is maintained notwithstanding the 
diseased action that is going on. It must 
be remembered that the lungs have two 
separate and distinct circulations, thtf' 
functional, derived from pulmonary ar- 
tery, and the nutritive, derived from 
bronchial arteries. We are told that the 
diseased action in pneumonia has to do 
chiefly with the functional blood vessels, 
and as a proof that the nutrient blood 
supply is not affected it is pointed out 
not only that the cell walls escape with- 
out material injury, but that the process 
of absorption can go actively on, as is 
evidenced by the rapid and complete re- 
moval of the exudate. The process of 
germ culture going on in the air cells 
generates a toxin which is at once ab- 
sorbed into the circulation and thus in- 
fects the system at large. All the evi- 
dences of virulent infection found in a 



90 



THE TRAINED NURSE AND HOSPITAL REVIEW 



typical case of pneumonia, the fever, 
chill, extreme prostration, etc., are due 
to the absorption of the poison, and as 
long as consolidation is spreading and 
the toxin being generated the toxaemia 
will be maintained. However, the me- 
dium can maintain germ life only for a 
limited period, and the organisms finally 
die and the generation of toxin ceases- It 
is supposed that it is when the supply of 
toxin is cut off that the temperature 
falls, also that defervescence will be by 
crisis in cases where effusion spreads 
rapidly and ends abruptly, and by lysis 
where the consolidation spreads more 
slowly, defervescence being prolonged in 
the latter case because toxin continues 
to be generated in one part as it fails in 
another. 

Scientists also advance the theory of 
the production in the lung of an anti- 
toxin which acts as a disinfecting force. 
The germs of pneumonia are sometimes 
found in the upper respiratory tract of 
persons in vigorous health, consequently 
it is considered that, while the essential 
cause of the disease is the development 
of a specific germ in the air cells, there 
must invariably be a contributing cause, 
something that renders the system sus- 
ceptible to attack. 

Certain determining and predisposing 
causes are well recognized, but their pre- 
cise relation to the specific cause is not 
understood. 

The most common determining cause 
is exposure to cold. Unsanitary living 
seems to be a common predisposing 
cause, people living in overheated, badly 
ventilated, crowded or dark dwellings 
being more liable to mcur an attack of 
pneumonia. Intemperance not only pre- 
disposes to pneumonia, but greatly les- 
sens the patient's chance of recovery. A 
former attack seems to predispose to a 



second attack and more males are at- 
tacked than females. 

Frequently, the very first symptom of 
an attack of pneumonia is the sudden 
onset of a sharp pain in the chest, gen- 
erally in the mammary region. Every 
movement of respiration aggravates the 
pain and the breathing is instinctively 
restricted. In some cases there is no 
sharp pain, but only a dull aching; in 
still others very little complaint of pain 
is made. The sharp pain is due to 
involvement of the pleura, pleuritis to a 
greater or less extent being present in a 
majority of cases. The dull pain has its 
seat in the lung tissue. As a general 
rule the pain lasts only two or three 
days, decreasing as consolidation becomes 
more complete, and the movements of 
the lung with resulting friction of pleural 
cavities consequently become less. A 
chill generally closely follows the pain, or 
it may be that the chill precedes the pain. 
This initial chill in different cases varies 
greatly in intensity and duration — it may 
be a severe and prolonged rigor, or, per- 
haps, little more than a chilly sensation. 
The severity of the chill is generally re- 
garded as bearing some relation to the 
severity of the infection, the chill oc- 
curring when the system first feels the 
shock of the poison that has been ab- 
sorbed into the circulation. 

In some cases, more often in the aged, 
there may be a general feeling of malaise 
several days before a seizure of pneu- 
monia, patient probably suffering from 
headache, loss of appetite, dull pains in 
back and limbs, and chilly sensations al- 
ternating with flashes of heat. 

Coincident with the initial chill comes 
the rise of temperature, which, within a 
few hours, may reach 103 degrees to 105 
degrees, or even more. The temperature 
is likely to remain more or less high 



THE TRAINED NURSE AND HOSPITAL REVIEW 



91 



until the crisis, when, within a few 
hours, it may fall to normal. The crisis, 
which is quite likely to occur at night, 
may be looked for from the 5th to the 
8th or 9th day. Defervescence some- 
times occurs by lysis, the temperature in 
such cases fluctuating considerably and 
gradually lowering to normal. The dan- 
ger may not be at all in proportion to the 
temperature, and too much importance 
should not be attached to it alone. It 
should be borne in mind that the greatest 
danger may be present when the fever is 
only moderate, and that it is as highly 
important to watch if the other condi- 
tions remain favorable as to record the 
temperature every few hours. Patients 
sometimes recover from extraordinarily 
high temperatures. The pulse, which at 
first may be firm, full and bounding, is 
likely, as disease progresses, to become 
more frequent and compressible, per- 
haps small and thready. The pulse is 
subject to great variations in sympathy 
with disturbances of the nervous sys- 
tem. In young children it may be very 
high without proportionate danger. In 
an adult a pulse that remains about or 
over 120 is a serious symptom, as is also 
a pulse that is feeble in proportion to 
temperature and respirations. Generally 
the pulse decreases in frequency with 
the fall of the temperature, and if it does 
not it may be of serious import, indi- 
cating that the infection has weakened 
the heart muscle. Heart failure is the 
chief danger in pneumonia, and to watch 
for any indication of it and be ready 



with remedies to promptly administer 
until the arrival of the doctor is a duty 
that constantly faces the nurse until her 
patient is quite convalescent. Upon the 
nurse thoroughly knowing the grave 
symptoms and being vigilant to recog- 
nize them, may depend the patient's 
chance of recovery. When grave symp- 
toms arise the doctor should at once be 
notified, but from the first the nurse 
should be provided with remedies to ad- 
minister in the event of a possible emer- 
gency during the physician's absence. 
While the nurse may be familiar with 
the remedies in general use and know 
when the patient's condition indicates 
their administration, her duty, of course, 
is to use the particular stimulant or other 
remedies that the attending physician 
favors and provides for the use of his 
patient. It is sometimes necessary to 
regularly give stimulants quite early in 
the disease. Whiskey or brandy is gen- 
erally freely used, often in conjunction 
with other remedies, such as strychnine, 
digitalis, nitroglycerine, etc. Oxygen 
given by inhalation is a remedy greatly 
relied upon in many cases. 

The pneumonia patient at first usually 
lies on his back, as respiration is gener- 
ally less painful in this position ; later he 
may change and lie on the affected side, 
there being thus less pressure on the 
sound lung. As he is likely to retain one 
position for a considerable time, precau- 
tions should be taken from the first to 
prevent any trouble arising from the 
continued pressure. 



(To be continued.) 



%ift importance of tije jaurst to tije pregnant 

tHontan 

A. p. REEO, M.D. 



T F every pregnant woman could have 
-*■ the great advantage from the begin- 
ning of her period, of a trained nurse, 
supplemented now and then by the visit 
of the physician, who is finally to attend 
her, many things of discomfort, both 
slight and serious, might be entirely 
escaped by the patient. I say patient, 
since every pregnant woman, if matters 
were as they should be, would be reck- 
oned a patient throughout her pcrio<l, 
rather than as simply a patient for the 
few hours previous to the birth of her 
child, and a day or two afterwards, as 
is too generally the case. Unfortunately 
. the world is yet so far from the ideal of 
Edward Bellamy as to make such an 
environment a rare exception for her 
whose important duty it is to nurture 
and mold the generations. However, 
there arc many more who could afford 
such care than actually avail themselves 
of it, and these, at least, should be 
reached as rapidly as possible in the in- 
terest of the human race as a vast whole, 
and be made to realize the great addition 
not only to their personal security, but 
to the improvement of the race that such 
a supervision means. 

Thus gradually might this field be 
entered further and further, being broad- 
ened continually by the convictions that 
inevitably accompany such an object 
lesson. 

Nurses themselves, as well as physi- 
cians, can do much to make such an 
idea prevail to a larger extent, not only 
in showing how useful those trained for 
the work can be. but by the inculcation 



as opportunity offers of the principles 
underlying such a purpose, first, of 
course, realizing themselves the full im- 
port of the matter. 

Among the graver things women 
might thus escape, none are more grave 
than puerperal eclampsia, and none, if 
taken early, are more amenable to hy- 
gienic management in quite a per cent of 
cases, and I may add, none make more 
strenuous demands on the physician and 
nurse, not only in treatment and inces- 
sant watchfulness, but in anxiety. 

The hygienic field of pregnancy is the 
one wherein the nurse may be of in- 
calculable benefit, and wherein she finds 
her chief duties. 

Of supreme importance in the main- 
tenance of health during this period is 
attention to the primae viae, as required 
to keep the bowels, kidneys and skin do- 
ing severally their duties in elimination, 
since many of the more serious compli- 
cations of pregnancy are due to defective 
elimination and the consequent harbor- 
ing within the system of dangerous tox- 
ins to be absorbed and reabsorbed. 

The patient's dress at this time, includ- 
ing the laying aside of corsets, and the 
avoidance of all pressure, suspending all 
weight from the shoulders, etc., are now 
so well understood as not to require di- 
lation here among so many less ex- 
ploited matters. There is the matter of 
nausea and vomiting, which, while, as a 
rule, is not persistent or violent, yet 
should be given as much relief as pos- 
sible in all cases. Previous to the calling 
of the physician for drug treatment, the 



THE TRAINED NURSE AND HOSPITAL REVIEW 



93 



nurse may try various measures with a 
reasonable assurance of relief, especially 
mild cases, such as a cup of tea, hot 
water, or an effervescent drink, perhaps 
a little champagne, confinement in bed, 
careful feeding, nutritive enemata, if 
necessary, giving the stomach rest. I 
have sometimes known a little wine of 
cocoa to give relief in these cases. 

A fair trial of these means with little 
or no mitigation, should be the signal 
for calling in the family physician. 

The golden rule of pregnancy is mod- 
eration in all things. The patient's ordi- 
nary tastes as to food and drink may 
usually be followed with safety. Stand- 
ing or walking for long periods v should 
be avoided. Everything should be made 
subservient to an abundance of sleep 
and fresh air. Luke warm baths with 
a little salt in the water may be given 
daily. 

One should also avoid long drives over 
rough roads, as well as crowds, especial- 
ly in over-heated halls. 

Withal, the nurse best fitted for these 
cases should have a sunny, cheerful dispo- 
sition, since most women at such a time 
need much kind encouragement and 
mental diversion to offset their natural 
forebodings, and to keep their emotions 
within bounds. 

This of itself furnishes reason enough 
for the companionship of a nurse, and 
another great blessing of the tactful 
nurse in the house is her ability to regu- 
late the woman's daily life so much 
more accurately than either she or her 
family can do it, regularity in all her 
habits having much to do with her 
healthfulness, and "health is the first 
wealth" here if anywhere! To bring 
order out of the chaos found in many 
homes in these cases, and institute system 
in the daily life is not least among the 
things that make a nurse indispensable. 



A time for everything, even to the 
moving of the bowels, will not only fur- 
nish the woman much immediate com- 
fort, but presage well for the comfort 
of her confinement, and also affect the 
vitality of the offspring, doubly insuring 
a healthy child of strong characteristics. 

As regards the bowels, if anything is 
needed beyond vegetables and fruits in 
the diet, not forgetting prunes, the nurse 
might use the compound licorice powder, 
or the compound rhubarb pill, with an 
occasional seidlitz. If there are signs of 
much bloating, resort may be had to a 
milk diet and quarter teaspoonful doses 
of cream of tartar in water every four 
hours while awake, may correct much 
of it, though, if it gets above the lower 
limbs, a physician had best be called. 
Should this condition be accompanied by 
headache, it implies that the need of a 
physician is urgent. 

Among regular things don't overlook 
regular, moderate exercise in the open 
air. 

The sphere of the nurse in pregnancy 
is chiefly in the field of prevention, the 
field of intelligent watchfulness for un- 
toward symptoms with a view to secur- 
ing early attention of the physician to 
these, and in the field of ministering to 
the immediate comfort of the patient, 
where she can come as near being a "min- 
istering angel'' as anywhere. 

While, as a rule, there is no special 
diet for pregnancy, yet certain indica- 
tions call for certain limitations, as in 
case, of serious vomiting, the stomach 
must have rest and a light diet, mostly 
fluid, taken in small and oft-repeated 
doses, a diet sometimes demanding pre- 
digestion, not forgetting the using of 
cracked ice, vichy, koumiss, milk with 
lime water or sodium bi-carbonate, but- 
tered cracker, sprinkled with a little 
cayenne pepper, clam broth, etc. 



94 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Some women have much rehef in sim- 
ply sipping very hot water. 

Albumen in the urine, of course, re- 
quires restriction of meats and other 
nitrogenous foods, and quite close con- 
finement to a milk diet, while, on the 
other hand, if the patient becomes 
anaemic, meat and the nitrogenous sub- 
stances are the very things we want. In 
constipation a diet of coarse cereals, 
fruits and vegetables, is often of great 
service. Sweets, pastry, rich sauces, 
highly spiced dishes and heating drinks, 
may, of course, work mischief. 



Some breasts at this time demand a 
little attention sometimes, when light 
massaging with cold cream, mixed with 
subnitrate of bismuth, will be found 
to help matters. I find, too, that if dur- 
ing the last weeks of pregnancy the 
breasts are bathed frequently with water, 
in which a little tannic acid has been 
dissolved, it seems to be a protection 
against sore nipples after labor. I trust 
I have given some hints that will prove 
of value to many in these cases, and that 
I have shown the importance of the 
nurse to the pregnant woman. 




MOSCOW HOSPITAL, MOSCOW, IOWA. 



(txtutts from t|)e journal of a ^upil 0m6t 



(Continued.) 



St. Andrew's Hospital, Feb. i. 
'' I ''HE days and weeks have slipped 

-*- away; Christmas Day (mildly 
celebrated in the hospital and the sad- 
dest, loneliest Christmas Day I have 
ever known — "Merry Christmas,'' — 
these words seemed a mockery, indeed), 
is a thing of the past, and a new year 
has been ushered in. "Happy New 
Year" has sounded through the Tiospital 
as in other places, but I could not help 
thinking how little happiness it promised 
to many within those walls. The month 
of January has passed, not altogether 
uneventfully, for no month can be said 
to so pass in an institution where every 
month, week, even day, brings its own 
changes — the month has passed in the 
changeful and eventful way inseparable 
from hospital life, and February has 
come. No longer must I neglect the 
journal which is to faithfully record my 
hospital life. 

When accepted as a pupil nurse I at 
once wrote glowingly to Aunt Katharine, 
telling of the great honor it was to have 
successfully passed through the trying 
period of probation, to have emerged 
covered with glory from the test of a 
stiff examination, and finally to be gra- 
ciously received and enrolled as pupil 
nurse in the highly select St. A's. But 
Aunt Katharine has evidently resolved to 
make full allowance for and give all due 
honor to the abilities and graces of her 
absent niece. She persists in treating 
my acceptance by the superintendent as 
a matter of course, and when I, much 
impressed by the solemn and binding na- 
ture of the contract I had just had the 
privilege of entering into, wrote to her 



stating that I had irrevocably signed, 
sealed and delivered myself to the service 
of St. Andrew's Hospital for the period 
of three full years, she promptly replied 
with the kind assurance that she con- 
gratulated the hospital. In writing to 
my aunt I have never admitted that even 
the glorious career of a hospital nurse 
has its drawbacks, but somehow she 
seems to suspect it. Of course, we have 
our trials, many of them, but we have 
our compensations, too. To my journal 
I admit that occasionally, even yet, I feel 
as if I were being enfolded by all the sor- 
rows, trials and pains in the big building, 
and my bursting heart is tempted to cry 
out, "I cannot stand it — it is crushing me 
— it is killing me — am I never again to be 
surrounded by other than grief-stricken 
people, never again to know what it is to 
be carefree and lighthearted ? Is my life 
henceforth to be spent in listening to 
troubles and moans, doubts and repin- 
ings, looking into pain tortured faces 
and hearing the lamentations of the be- 
reaved?" At such times how thankful 
am I to escape to the Nurses' Home for 
even the short and hurried ten minutes 
allowed us in the morning. Then, per- 
haps just when I am feeling so unhappily 
blue, some poor man, sick unto death, 
will murmur, "God bless you. Nurse, for 
your kindness to me,' or maybe the old 
Irishman who has patiently borne suffer- 
ing for months will smile his cheerful, 
sunny smile, and say, as he often says, 
"Sure, Nurse, ye're a rale angel, so ye 
are. Whativer would become of us 
poor sick men without the loikes of ye?" 
And the clouds will lift and magically 
roll «a way. Then, indeed, I know that 



96 



THE TRAINED NURSE AND HOSPITAL REVIEW 



nothing in my old life of pleasure could 
compensate for a loss of the opportuni- 
ties for helpfulness that my present life 
affords. And though we see tragedy, we 
see joys too; though we hear heartbroken 
lamentations, we also hear gjad words of 
rejoicing over the happy result of our la- 
l)or to draw back somebody's loved one 
from the brink of the grave ; though we 
encounter grumblings and unjust criti- 
cisms, we also meet with heartfelt thanks 
and praise, sometimes far beyond our 
deserts. And in the midst of the rush 
of work, the daily grind that marks the 
nurse's life, the sights and sounds that 
unnerve those unaccustomed to them, I 
am learning to live and be happy. 
♦ **♦*** 

I was initiated into lectures (the in- 
structive kind) long ago, but to-night I 
attended my first lecture on anatomy. 
Dr. Summers, who lectures on this sub- 
ject, has been absent from the city for a 
while, otherwise I presume I would have 
had the privilege of hearing him sooner. 
Dr. Summers impresses me as being the 
most kindly, careful and unassuming of 
men, and if any one ever graduates from 
our school deficient in knowledge of his 
subject it is safe to say it will not be the 
fault of the lecturer. 

Upon entering the lecture room to- 
night I stopped short and gave an involun- 
tary startled gasp as my glance was ar- 
rested by something suspended from the 
chandelier. It was a human skeleton, 
the first I ever saw. Upon a table be- 
neath were littered many human bones, 
great and small. "Horrors!" I thought. 
but did not say. I am glad to remember 
that I had sufficient presence of mind 
and self control to enable me to refrain 
from following a natural impulse to 
shriek it aloud. After the first shock I 
did my best to suppress all emotion#but 



an uncomfortable, creepy sensation has 
kept me company all evening. I hope no 
one noticed my occasional shudders, for 
beside the calm, matter-of-fact profes- 
sional exterior of the other nurses any 
emotional display on my part would have 
been in very bad taste. Toward the close 
of the lecture those bones were handed 
round for inspection, but whenever they 
came my way my note book or something 
demanded my attention, and they were 
passed across to my roommate, Miss 
Ashley, who received and handled the 
horrible "specimens" very coolly, caus- 
ing me thrills of wondering admiration. 
However, Miss Ashley is a doctor's 
daughter and her nerve is probably he- 
reditary. After Dr. Summers left two 
of the senior nurses, to my unspeakable 
horror, begged Miss Gray's permission 
to carry the skeleton over to their room 
in the Nurses' Home. They want it as 
an aid in studying the articulations, they 
said. Approving, I presume, of their 
diJigence in the pursuit of knowledge 
Miss Gray consented. With their own 
hands they bore the skeleton triumphant- 
ly away, and it now swings from the 
chandelier in their bedroom. And at the 
present moment I can hear those two 
girls with that awful grinning skeleton 
occupying their room, laughing and chat- 
ting and telling mirthful stories, actu- 
ally laying bright plans for the future, 
quite heedless of the dread fu] reminder 
of human mortality swinging under the 
gas. 
******* 

Many and varied are the experiences 
of hospital life. Much that occurs may 
soon be past and forgotten, but some 
things there are that can never be for- 
gotten. Seeing so much pain and misery 
in the lives of those around us, hearing 
so frequently sad little histories from the 



I 



THE TRAINED NURSE AND HOSPITAL REVIEW 



97 



lips of the sick, spending nearly all our 
waking hours in the society of the 
afflicted — what wonder if we should 
sometimes be prone to forget that the 
world knows pleasure as well as sorrow. 
As a matter of fact, though, it is but 
rarely that nurses give evidence of any 
such feeling. Nowhere have I ever met 
a brighter, more cheerful set of girls. 
We are hardened to the sight of suffer- 
ing, people say, when they see us calm 
and apparently unmoved quietly standing 
by or as quietly rendering assistance to 
the mutilated victim of some horrible 
accident. We have, they think, become 
so callous that human suffering makes 
no impression on us. Well, perhaps we 
are hardened in a way; still if I can an- 
alyze my own feeHings correctly I think 
that I am just as sorry for the patients 
now, not to mention being decidedly 
more helpful, as during my first days in 
the ward, when I used to feel inclined to 
scream and run away whenever a new 
accident case came in. Yes, I maintain 
that I do still pity the patients, even 
though I manifest it by doing all I can 
for them instead of fleeing away to in- 
dulge in hysterical weeping. The real 
difference. I think, lies not in the fact 
that I have become indifferent and heart- 
less, but rather in the fact that I have 
learned self control and that I am not 
quite so selfish now. To try to forget 
that you have sensitive feelings that 
ought to be shocked by harrowing sights 
and sounds, to make an effort not to 
selfishly dwell upon the effect on your 
own nerves, but rather to cultivate the 
habit of remembering that sick individu- 
als have more need of calm, swift, prac- 
tical aid than of hysterical tears and con- 
dolence, is in many cases, I am sure, the 
real secret of the hardening process of 
vvliicli some people speak so freely. I 



mysdlf used to be shocked to see the 
nurses leave some melancholy scene in 
the hospital and go to the Nurses' Home 
immediately to indulge in light talk upon 
some subject entirely foreign; but I am 
shocked no longer. I merely think now 
what a good thing it is for themselves, 
also for their patients, that they have 
been able to acquire the habit of quickly 
passing from the grave to the gay. I en- 
courage myself to forget the hospital and 
all in it as soon as I leave it at night — I 
do not succeed very well, though. But 
indeed, it is a blessing that we can some- 
times forget. Otherwise, what gloomy, 
sad creatures we would become. 

:|< :iJ ^ * :|: * * 

A blue and white striped dress and a 
cap for wear in a hospital ward bring in"^ 
creased responsibility, but they certainly 
confer advantages. Since I have worn a 
uniform I have from time to time had 
so many nice things said to me by pa- 
tients and their friends that I might be 
growing quite foolishly vain but for the 
wholesome counteracting effect of Miss 
Gray's searching eyes and the head 
nurse's impartial criticisms. Flattering 
speeches notwithstanding, one does not 
readly grow vain in a hospital ward — 
your head nurse and lady superintendent 
have an unflattering way of seeing to 
that. To-day Miss Gray personally 
took me to task because, to quote her 
own words, "a nurse who has been a.-; 
long in training as yourself, Miss Bal- 
lantyne, should now know at least how 
to make a bed properly.'' Of course, the 
bed that caused the complaint was not, 
I admit, particularly well made, accord- 
ing to the hospital standard, at least; 
but my patients demanded so much of 
my attention that I really had hardly a 
minute to give to the making of that 
empty bed. It would have been much 



98 



THE TRAINED NURSE AND HOSPITAL REVIEW 



better made if I hadn't, while making it, 
been interrupted a dozen times, but Miss 
Gray never seems to consider interrup- 
tions or extra work any excuse. We are 
shown one certain way of performing 
each duty, and woe betide her who fails 
to adhere to the accepted method. To 
say that any tendency to experiment and 
find another, perhaps a better, way of 
doing things is distinctly discouraged is 
putting it mildly, very mildly, indeed. 
The elaborate procedure followed in the 
making of beds is a fair sample of the 
rigid attention to trifling details exacted 
in the performance of all hospital duties. 
Before I came here I thought I had fully 
mastered the simple accomplishment of 
making a bed, but now after many weeks 
of daily struggle to perfect myself in 
the art I feel less confident. Simple ac- 
complishment, indeed ! Not as perfonned 
in St. Andrew's Hospital. No mere 
words of mine can do adequate justice 
to a lesson in bed-making as given by my 
head nurse. Long shall I remember my 
first lesson. "First remove the bed- 
clothes. Miss Ballantyne," said Miss 
Raymond, indicating the unocaipied Ijed 
upon which I* was to demonstrate my 
skill. I was pleased to find the first re- 
quirement so simple, for I had heard the 
other probationers discuss the difficulty 
of making beds to please their respective 
head nurses, and their remarks had led 
me to think that there must be in vogue 
in the hospital some extraordinary 
method by which an ordinarily easy task 
was rendered a very arduous one. So, 
much relieved to find that the initial 
stage presented no difficulty and actu- 
ated by a sincere desire to please Miss 
Raymond and demonstrate my zeal in 
the performance of duty, I seized the 
bedclothes, hauled them off and was 
about to deposit them in a confused 



heap on the nice white floor, when — 
"No! No! No!" came in horrified ac- 
cents from the head nurse. "My con- 
science. Miss Ballantyne, not on the 
floor !" Thereupon, she proceeded to in- 
struct me regarding strange new things 
that she cabled microbes, bacilli and 
bacteria. 

Following her directions, I removed 
the clothes gingerly, one piece at a time, 
and placed them high and safe away 
from the pestilential floor, a deceitful, 
hypocritical floor I thought it to display 
such a cleanly innocent appearance. 
When a corner of a blanket or a sheet 
hung down, I religiously tucked it up 
lest a microbe should catch sight of it 
and by making a sudden dash and leap 
reach it and destroy its purity, even 
cause the death of some innocent man 
possibly, so dire are its ravages accord- 
ing to the authority of my head nurse. I 
suggested to her that first day that if 
the microbes and their kin wanted very 
badly to get into a bed they might easily 
accomplish it by crawling up the iron 
legs. 

As the bed-making proceeded I grew 
in knowledge of its difficulties. The 
.=iheets must be placed just so. with their 
hemmed ends turned one certain way ; 
the blankets likewise must be placed 
with great exactness, not a tenth of an 
inch further down on one side than the 
other; the white coverlet must be laic' 
with geometrical precision, its ends be- 
ing turned and folded in a very special 
way, while the pillows are shaken ii > 
and beaten down and flattened out an ! 
smoothed until they resemble paddxl 
boards. 

Finally one padded board is laid flat 
at the head of the bed and the other 
made to assume a bolt upright sentinel- 
like position on top of it. When with 



■I 



THE TRAINED NURSE AND HOSPITAL REVIEW 



99 



the head nurse's aid my first bed was 
completed, she drew me back a littje dis- 
tance and surveying it with pride desired 
me to observe the beautifully smooth, 
ornamental appearance it presented. To 
me it looked like a shallow white box on 
slim legs; but smooth and even it cer- 
tainly was, and I said so with haste and 
eagerness, being in mortal fear lest the 
head nurse should discover some fancied 
flaw and insist upon my doing it all over 
again with the aid of a carpenter's 
square and spirit-level. 

My private opinion is that as long as 
the patients, poor things, are clean and 
comfortable, it is not a matter of tre- 
mendous importance which hem, broad 
or narrow, happens to be tucked under 
the head of the mattress, or whether the 
end of a white coverlet is a sixteenth of 
an inch lower or a full quarter of an inch 
higher than the prescribed line. To-day, 
when found fault with, I was foolish 
enough to express these radical views to 
the superintendent herself. Alas, their 
reception was not such as to encourage 
future arguments in their favor. So I 
must wisely resolve to drop prejudice 
henceforth and devote my energies to 
perfecting myself in the art of letting the 
patients wait while I take lime to make 
empty beds in the orthodox way. I fore- 
see that in time, with sufficient persever- 
ance, I may even attain such excellence 
that I shall be more shocked and grieved 
at sight of a disordered coverlet than on 
account of the patient whose painful 
writhings toss it out of order. Only to 
the privacy of my journal dare I trust 
the heresy, but I here confess that I 
sometimes think that there is just a little 
too much stress laid upon the things that 
count only for appearance and not quite 
enough upon some other things that tend 



more directly to make the patients com- 
fortable and happy. After all, the hos- 
pital was, I suppose, originally planned 
and built for the express purpose of tak- 
ing care of sick people and alleviating 
suffering, and I imagine that it isn't now 
maintained primarily for showing long 
rows of evenly hanging window shades 

and displaying show beds. 
******** 

I am writing to-night in a new room. 
Miss Ashley and I hkve given up our old 
room, the Orphans' Home, as it was long 
ago nicknamed, in order that it might be 
taken possession of by newly arrived pro- 
bationers, it being an unwritten but un- 
broken law that newcomers first occupy 
the rooms at the end of the corridor, be- 
cause (as we considerately agree now 
that we have left them) they being the 
most barren and devoid of comfort, are 
specially adapted to the use of probation- 
ers, being particularly well calculated to 
test the stuff the "probes" are made of. 
The advent of new probationers marks 
an era in the lives of those of us who 
were probationers last fall. We are no 
longer to be slightingly referred to as 
the "probes," and, better still, we have 
at last an opportunity to give ourselves 
little airs of wisdom and condescension 
considered to be highly edifying to the 
new arrivals. At last we may graciously 
patronize or gaze with calm superiority 
upon wide-eyed, timid, bewildered young 
women, and wonder to each other "why 
on earth those probes haven't more self- 
possession." It is, too, so very nice and 
soothing to know that they are dazzled 
by our accomplishments and envious of 
our remarkable knowledge and wonder- 
ful skill. Oh, indeed, I realize now that 
in some respects probationers are much 
appreciated by the older nurses. 



Clje "ETifiiting iSursc— ^ome CjrperitnteiS 



B. B. M. 



BEFORE leaving the hospital I had 
decided to do district nursing, 
so even before graduating I sent 
in my application to the Victorian 
Order of Nurses for Canada, and six 
months later was a district nurse in 
Montreal. At that time the Order 
maintained a home in charge of a dis- 
trict superintendent. There was an as- 
sistant and seven nurses in training. 
One of these was stationed at Pt. St. 
Charles, a suburb of Montreal, and one 
was night nurse, who, when she had no 
calls after midnight, helped with the 
morning calls. 

My first morning's work was on a 
Sunday. I made rounds with the as- 
sistant and we visited three cases. 
Our first visit was to a young Eng- 
lish woman with her first babe. 
The next visit was to a Jewish home, 
and there also was a new babe. The 
patient could not speak English very 
well and we did not see much of the 
other members of the family. The 
father and sons had prayers in the hall 
while we were there. An old lady, who 
was a paralytic, received the last visit. 
She and her daughter, who taught 
school, lived in one room. The patient 
was bathed, given an alcohol rub, 
dressed and fed her dinner. She wanted 
to know where I came from and when 
told west of Chicago said, "Huh, I'm 
not partial to the Yankees." I visited 
this old lady for weeks and one day she 
admitted, "The Yankees are not so 
bad." 

After my first month's work the re- 
maining three months I had charge of 



the chronic cases. An old lady dying 
of cancer was one of my patients for 
weeks. She lived in a poor house with 
her easy-going husband, two sons and 
a little granddaughter. A daughter, 
who lived near, came in every day to 
get dinner for them, and occasionally 
would do house cleaning. Every morn- 
ing after the dressing was done, the old 
lady was given a stimulant. At my first 
visit I did not know there had to be 
any secrecy about it, and when she 
asked for her whiskey and told me to 
call the old man to get it ready, I 
shouted down the stairs for the old 
man to come up and get the whiskey. 
"Oh, don't let the boys know I have 
whiskey. I keep it hidden under the 
mattress. If they knew I had it and 
knew where I had it they wouldn't 
leave any for me." We visited this 
patient several months and after her 
death the superintendent sent in a bill 
for ten dollars (less than ten cents per 
visit) and the old man called at the home 
to do some gardening to pay his bill. 
He did about one day's work for his 
ten dollars. 

GriflFentown was always an interesting 
district to me, and I think it was to 
most of the other nurses. For some 
time I had a little boy suffering with 
articular tuberculosis. I visited him 
three times a week. The family lived in 
a four-room flat, very poorly furnished 
and where the kitchen table was always 
covered with food and dirty dishes. The 
last I knew of the little boy he was in 
a children's hospital and was incurable. 

I remember hearing one of the other 



THE TRAINED NURSE AND HOSPITAL REVIEW 



101 



nurses tell of an experience she had 
in Griffentown. The case was a col- 
ored woman who had been confined 
several days before and this morning 
when the nurse called she found the 
house full of smoke — the stove pipe 
had fallen down — the husband was 
away at work and the children were too 
young to go for help. The nurse was 
up on a chair adjusting the stove pipe 
when the doctor came in. He seemed 
to think it was quite funny, but said 
he was glad she was ready for any 
emergency. 

I once had a patient in a houseboat. 
They were New Yorkers and had three 
children. They had one good-sized 
room and a very small kitchen about 
five feet square. Their table was a 
drop shelf, the chairs were all camp 
chairs, and the children's bed pushed 
back into the wall. The other bed was 
iron, but a very small, low one. 

I visited a tubercular case more than 
one year. This patient was not ex- 
pected to live three months when I 
first called. The case was reported by 
a woman Mrs. C. had worked for, and 
our bill was paid by her. Mr. C. made ' 
good wages, but the old story, "He 
drank." Mrs. C. lived on the outskirts 
of the town and I had eight blocks to 
walk after getting off the car. The 
house would have been a very com- 
fortable one, but Mrs. C. did not always 
have fuel, and I think she often suffered 
on account of the cold. I found her 
very weak and uncomfortable, but she 
wanted a bath an^l an alcohol rub. 
While I was there a representative of 
the Tuberculosis League called to bring 
some beef tea. Mrs. C. had three chil- 
dren. At Christmas we sent them a din- 
ner, some toys and some clothes, I had 
promised Mrs. C. I would stay with 



her when she was dying. One night a 
neighbor telephoned me that Mrs. C. 
had been very low all day and asked 
me to come out as she didn't think Mrs. 
C. could live through the night. It was 
eleven when I received the message, 
and on account of the distance and 
scarcity of cars it was after twelve when 
I reached her. Mrs. C. was some bet- 
ter, but I stayed until morning. I slept, 
or at least tried to sleep, in a Morris 
chair, but the fleas did not give me 
much peace. This was' in October, 
and Mrs. C. lived until February. We 
had loaned them an air cushion, and 
when the nurse called for it, Mr. C. 
said he had sold it. 

I had another tubercular patient who 
had one little girl six years old, whose 
whole ambition was to be a nurse. These 
people owned their home and lived in the 
front rooms upstairs and rented the 
remainder of the house to three fami- 
lies. At the same time I was visiting 
the patient upstairs I had a patient 
down stairs. This man had diabetes. 
He was taken to the hospital and his 
wife and little boy lived on In their two 
rooms — the mother going out as a char 
woman in order to make a living. I got 
the little girl who wanted to be a nurse 
an old bag from another patient and I 
gave her a note book and pencil. She 
made herself an apron of red calico and 
with her bag filled with old rags she 
would play nurse hours at a time. 

Another family, of little girls were 
very fond of playing nurse, and one 
morning the mother heard them disput- 
ing as to' whom should be nurse, and 
was very much amused to hear one say, 
"You can't be nurse ; you have red hair 
and nurses never have red hair." This 
was a confinement case and they both 



102 



THE TRAINED NURSE AND HOSPITAL REVIEW 



wanted the pleasure (?) of bathing the 
babe (a doll). 

After my four months I went to Chi- 
cago to take a post-graduate course at 
the Chicago Lying-in Hospital. Two 
weeks of the three months were spent in 
the dispensary'. A student and nurse 
made rounds together and would visit 
five maternity cases in a morning. One 
cared for the mother and the other for 
the babe, changing at the next place. 
Before returning to Montreal I did six 
months' district work in Chicago. My 
district covered such a large territory I 
seldom made more than ten visits a 
day. My mother came to visit me and 
one day she made rounds with me. It 
was "office day" and so we made only 
eight visits. She said she had no idea 
there were so much poverty and misery 
in the world, and couldn't understand 
how I could smile when I went into 
their homes. One family, who were 
squatters, and where the mother was 
dying of tuberculosis, appealed to her 
very much. The husband when he was 
not drinking was a night watchman. 
The three little boys were newsboys and 
were very good to bring the pennies 
home to their mother. A babe about six 
months old was taken to the day nurs- 
ery every morning. 

We visited an old Frenchman who, 
with his wife, lived in two small rooms 
and who received a daily visit. On Sun- 
days and holidays he would not let his 
wife wash his face even because "she is 
too rough." The wife, who was seven- 
ty-eight, did all their washing and kept 
that old man and his bed as neat as 
wax. I think they depended almost 
altogether on charity. 

Late at night there was a new case 
to visit and we had a great time to find 



it. The streets were not cut through 
and our walk was rather roundabout. 
We found a man very ill with tubercu- 
losis and as his mother had g^ven him 
care that day, I just took his tempera- 
ture. The following morning I went 
out and gave him a bath and an alcohol 
rub and a day or so later he was taken 
to Dunning. 

The following Spring I returned to 
Montreal and was engaged in the work 
there for over three years. I was given 
a district and was centrally located in 
it. In 1904 the order gave up the 
home, divided the city into districts with 
a nurse in each district. The work has 
grown and now there are twelve nurses 
on the staff. My district was in a new 
part of the city and the car service was 
poor at times, especially after a heavy 
snowstorm, so I often had difficulty in 
getting to my cases. One afternoon I 
think I spent all of two hours hunting 
a case. I found an old lady very ill. 
I gave her a bath, changed her linen 
and made her bed. I left with the un- 
derstanding if they wanted another visit 
they would telephone, but she died that 
night. 

I am now doing district nursing in a 
small town where I do not come in con- 
tact with the poor people as I did in the 
city. I think I prefer the poor people. 
Some of these poor things have no one 
to speak to but the nurse. She is 
generally a good listener and they tell 
her all their troubles. I have had dis- 
couraged people tell me just having 
some one come in that they could talk 
to has done them good. I often think 
almost all we hear is people's tales of 
woe, but we do also hear "Thank you," 
"God bless you," and 'When arc you 
coming again?" 



91 jBteto Slnaestljetic 



C. M. PLATT. 



SOMNOFORM has come to my ob- 
servation through the kindness of 
a dentist living in the same building 
where I have my room. 

The first time I saw it administered, I 
will confess that its action was so rapid 
I hardly realized that the patient was 
anaesthetized before the tooth was ex- 



ness, and for about five minutes a dizzi- 
ness. 

Patient No. 3 — a young man. He was 
under the anaesthetic one minute, his 
•pulse quickened slightly and he kicked a 
little. This was the first excitement with 
Somnoform that I have seen. The pa- 
tient had no after effects, in fact, he be- 




tracted and the patient looking around. 
Seventy seconds is not very long. 

Patient No. 2 had a lesion of the 
mitral valve of the heart. This pa- 
tient was under the anaesthetic three- 
quarters of a minute. At first (ten sec- 
onds) the pulse was quicker and then 
returned to its normal rate. The respira- 
tion was deep and somewhat slower than 
normal. The only after effect this pa- 
tient complained of was a slight drowsi- 



INHALER. 

Pneumatic face rest. 

Celluloid cone. 

Hole for air In metal 
tube, can <be opened or 
closed at 'Wlll. 

Rubber bag for Somno- 
form. 

Metal tubes. 
6. Metal drop for Somno- 
form. 



gan to smoke a cigar as soon as he was 
out of the chair. These patients were 
each given three C. C. of Somnoform. 

"At a dental clinic in Chicago Somno- 
form was administered to thirty-four 
patients, ranging from 11 to 76 years, 
and of different physical conditions 
(good or bad). The heart action of all 
was good, and only one of the thirty- 
four patients reported a slight nausea." 

Somnoform is a comparatively new 



104 



THE TRAINED NURSE AND HOSPITAL REVIEW 



anaesthetic, having been discovered by 
Dr. Rolland, of Bordeaux, France, in 
1895, and has been used to some extent 
since that time, with only four as a death 
list. It is composed of ethyl chloride, 60 
per cent; methyl chloride, 35 per cent, 
and ethyl bromide, 5 per cent. It has a 
pleasant pungent odor, easily inhaled. 

It is given in an inhaler somewhat dif- 
ferent from others. It consists of a 
metal and celluloid face piece, with a 
short metal tube connecting it with a 
large rubber bag. 



A physician of prominence writes : 
"As regards convenience Somnoform 
stands alone in the ease of administra- 
tion, speed with which anaesthesia is in- 
duced, the duration of anaesthesia and 
the speed and completeness of recovery." 

To me it is an ideal anaesthetic, as it 
can be used in minor surgery and as a 
preliminary anaesthetic. 

It is hoped it will be taught more ex- 
tensively in the medical schools, as some 
of the medical students I have talked 
with about it have never heard of it. 



The Closing of the Cambridge School 

The report of the Cambridge School 
of Nursing, sometimes called the Har- 
vard School of Nursing, which appears 
in another part of this number, is of in- 
terest because it marks the passing of 
one of the most important movements 
for the higher education of nurses which 
has taken place in this country. Those 
who have been most enthusiastic in the 
support of this school have been forced 
to admit that there is not a demand at 
present for this kind of training. The 
report is also of interest because it adds 
to the weight of evidence that there is a 
shortage of probationers, and that women 
are entering every other occupation than 
that of nursing. Why is this? 
••• 
A Correction 

In the December number of The 
Johns Hopkins Nurses' Alumnae Maga- 
zine we find the following: "We make 
no comment on the recently publishe<l 
statement that the Harvard School of 
Nursing, intended to turn out finished 
graduates in two years' time, and opened 



with much flourish of trumpets some 
two years since, has now closed its 
doors for want of applicants.*' 

We beg to inform our esteemed con- 
temporary that the Harvard or Cam- 
bridge School had a four years' course, 
and did not attempt to "turn out finished 
graduates in two years time," and the 
length of course was one of the potent 
factors in its lack of applicants. 



International Congress on Tuberculosis 

Active preparations for the In- 
ternational Congress on Tuberculosis, 
to be held in Washington next Sep- 
tember, are under way in other coun- 
tries. The National Committees for 
France, Germany, Sweden, Austria, Hol- 
land, Greece. Bulgaria, Cuba, Venezuela, 
Brazil and Costa Rica have organized 
and have forwarded their membership 
lists to the secretary-general. The 
French committee has a membership of 
over three hundred and includes men of 
prominence in public life, as well as in 
the medical profession. 



Clie ©let McJjen 



ROSE R, GROSVENOR. 
Past Diet Matron, Iowa Soldiers' Home Hospital. 



Poultry 



IN its strictly technical sense the word 
''poultry" is used to describe that 
class of birds which are domesticated 
for their flesh or eggs and used for food, 
the class including all, except pigeons 
and squabs, which are usually classed 
with game. As regards the composition 
and food value of all varieties of poul- 
try in general, a study of their consti- 
tuents, as given below, compared with 
those of animal flesh, will show that they 
do not differ as much as is commonly 
supposed. According to the United 
States Government analysis, the edible 
portion of turkey contains: Protein, 
22.2 per cent.; fat, 18.9; ash, 1.2, and 
water 57.0 per cent. That of chicken 
and fowl, protein, 21.9 per cent.; fat, 
8.9; ash, I.I, and water, 68.4 per cent. 
Ducks, protein, 18.3 per cent.; fat, 19.0; 
ash, 1. 13; water, 61.1 per cent. Geese, 
protein, 16.6 per cent; fat, 28.7; ash, 
I.I, and water, 54.0 per cent. These 
statistics show that as regards poultry 
of different kinds the light fleshed birds 
are richer in protein and poorer in fat 
than the dark-meated varieties. As far 
as the nutritive value alone is concerned, 
the one advantage of poultry over the 
other meats, as proved by scientific test, 
is, that although it furnishes less of en- 
ergy-giving material than the fatter 
meats it contains very slightly more of 
the building material needed by the body. 



Considering the matter of digestion, re- 
liable reports on artificial digestive ex- 
periments show that there is not as much 
difference in the digestibility as com- 
pared with other meats, neither is there 
any material difference in the digestive 
qualities of the light and dark meat, as 
is often stated. On the average, poultry 
is very slightly more easy of digestion 
than beef or mutton, the difference be- 
tween the various kinds depending on 
the amount of fat they contain, the fat- 
ter sorts, being least easily digested, and 
for that reason being considered unfit 
for invalid diet. 

Nothing is of more importance to the 
consumer than to know how to distin- 
guish between good and bad, or young 
and old birds, as great care should be 
exercised in the selection of poultry for 
food, that it may not be too old, or too 
long killed to be palatable and healthful. 
Several reliable methods for ascertain- 
ing the age and quality of the various 
varieties of dressed poultry are as fol- 
lows: First, the best grade of chicken 
or fowl should have yellow legs, well 
rounded form, skin light yellow, free 
from blotches, and the flesh fine and 
grained, combined with a medium 
amount of fat, which should be neither 
too hard nor too flabby. To test the age 
of all birds, press the skin under the 
wing or leg. If it be easily broken and 



106 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the point of the wing yields easily, or the 
breast bone is soft and pliable, it is cer- 
tain to be young. With ducks and geese, 
a flexible windpipe also denotes youth. 
A young turkey is usually plump, while 
an old bird is detected by the purplish 
flesh on legs and back. The hen turkey, 
though not as large, is usually fatter, 
more tender and the best to choose for 
all purposes. Although all varieties of 
poultry are found in the markets the 
year around, turkey is at its best in the 
fall and winter months, young geese 
from May until early winter, fowl from 
March until June, and spring chicken 
from May to October. As poultry can 
generally be purchased already dressed, 
it will be unnecessary to give details 
here as to the first steps in preparation, 
i. e., plucking and drawing. It will be 
sufficient to say, always go over the bird 
thoroughly with a short, stiff-bladed 
knife and remove all pin feathers, then 
singe and remove the oil sack. If the 
bird is to be stewed, fricasseed, fried, 
broiled or made into a pie, it should 
be cut into convenient pieces, cleansed by 
quickly rinsing in several waters and 
drained well. If the bird is to be left 
whole for roasting, it should be rinsed 
inside and out by holding under the 
spigot and then drained and dried be- 
fore stuffing. The giblets should be 
saved, cooked tender, then chopped fine 
and added to the stuffing or sauce. If 
the bird is to be broiled, the breast and 
back portions should be covered with a 
folded towel and pounded flat, that they 
may more easily cook even. The methods 
of cooking poultry are those ordinarily 
used^ in cooking other meats, boiling, 
stewing, roasting or fricasseeing being 
the best adapted for fowl, while broiling, 
frying, or sauteing is generally chosen 
for the young chicken. Turkeys, ducks 
and geese are best left whole stuffed and 



roasted. And they, with old fowl, are 
much improved if parboiled 20 to 35 
minutes before roasting. For the stuff- 
ing, bread dressing may be varied in 
many ways by combining and seasoning 
with sage, celery, oysters, onions, chest- 
nuts, the giblets, etc., as taste and the 
variety of the bird demand, sage or 
celery, being particularly adapted to 
roast chicken and fowl, and chestnuts or 
oysters with turkey, while onions are 
supposed to be indispensable in a good 
roast duck or goose. Besides the methods 
of preparation given above, cook books 
suggest almost endless numbers of fancy 
dishes, the difference between them 
usually being in the way they are flav- 
ored by sauce or dressing. 

The length of time required for cook- 
ing depends largely on the bird, its age 
and toughness, method of cooking, fuel 
used, etc., long, slow cooking, as in stew- 
ing, softening the fibers more thoroughly 
than a shorter exposure to intense heat, 
as in roasting. A large or old bird, of 
course, needs a longer exposure to the 
heat than a small or young one. The 
general rule for stewing chicken or fowl 
is 20 minutes to the pound, for roast- 
ing chicken, fowl and turkey, 20 to 30 
minutes per pound. Ducks and geese, 
having much tougher fiber, require 25 to 
35 minutes per pound. For broiling 
spring chicken, allow 20 minutes in all; 
old chicken, 35 minutes. Steadfast rules 
cannot always be adhered to and modifi- 
cations must be made to cover condi- 
tions. The principal requirements are to 
have the bird well done, well seasoned, 
juicy and tender, and, lastly, tastily 
served with appropriate sauces and gar- 
nishing. Some of the appetizing sauces 
for the individual varieties are celery, 
oysters, giblet or brown sauce as an ac- 
companiment to roast turkey or chicken ; 
brown, onion or tartare sauce with 



THE TRAINED NURSE AND HOSPITAL REVIEW 



107 



(lucks and geese; cream sauce with 
fried chicken, and celery or oyster sauce 
with a boiled fowl. In the way of a 
relish, tart apple sauce should be served 
with roast goose, cranberries with any 
sort of broiled bird, roast turkey and 
duck. Special gooseberries or currants 
also are excellent served with roasted or 
sauted poultry. Either lemon jelly or to- 
mato aspic in tiny molds, stoned olives, 
watercress or parsley are all quite suit- 
able for use as a garnish. 

TO ROAST A TURKEY OR GOOSE. 

Parboil and stuff with dressing to suit. 
Sew up opening with twine, draw the 
skin of the neck over the bone and tie 
down to the back. Lay the tips of wings 
under the back and fasten with a skewer ; 
draw the legs close to sides and tie 
underneath the back. Rub thoroughly 
with salt and pepper and lard, with tiny 
strips of bacon laid under the bird and 
across the breast. Roast in moderate 
hot oven until tender, basting frequently. 

CHESTNUT STUFFING. 

Shell and blanch three cups French 
chestnuts. Cook them soft in boiling 
salted water. Drain, mash and add one- 
fourth cup butter, one teaspoonful salt, 
one-third teaspoonful pepper and one- 
fourth cup cream, melt one-fourth cup 
butter, mix with one cup cracker crumbs, 
and then combine the mixtures and mix 
well. 



GIB'LET SAUCE, 

Clean and boil giblets in salted water 
until tender. Chop fine and after re- 
moving bird from pan pour in the stock 
giblets were boiled in, add the giblets 
and thicken a little with flour and season 
with a little butter and pepper. 

SAUTED CHICKEN. 

Cut up chicken, wash and dry well, 
roll pieces in flour and saute until tender 
in equal parts of hot lard and butter, 
seasoning well with salt and pepper; 
when tender, take up. Then add to 
gravy one-half cup sweet cream, one-half 
cup boiling water and large piece of but- 
ter rubbed in flour and a little salt. Boil 
up until creamy and pour over the 
chicken, 

CHICKEN PIE WITH OYSTERS. 

Cut up and stew a young chicken until 
tender. Drain the liquor from a quart 
of oysters, line the sides and bottom of a 
two-quart bake-dish with rich paste, put 
in alternate layers of fresh oysters and 
chicken until dish is full, season with 
salt, pepper and bits of butter and one- 
half each of the chicken stock and oyster 
liquor; cover with crust and bake about 
35 minutes. 

BROILED BREAST OF CHICKEN. 

Pound flat the breasts of young chick- 
ens. Lay on a greased broiler and broil 
until tender, turning often. Season when 
done and serve on a hot platter gar- 
nished with parsley or celery tips. 



Personal 



Miss Mary Rodgcrs, who for the past four 
years has been matron at the Emergency Hos- 
pital, Nashua, N, II., has resigned her posi- 
tion and gone to Lynn, Mass., where she is 
to conduct a private hospital. Miss Rodgers 



is a graduate of the Massachusetts General 
Hospital and during her term of service in 
this city made many friends. She was given 
a vote of thanks for her faithful service at 
the Nashua institution. 



Ctritoriallp ^peafemg 



The Problem of the Hospital and 
Training School 

A CONTEMPORARY spcaks editorially on 
"The Hospital's First Duty/' stating with 
plainness and emphasis that such duty 
is "the care of the sick." This is so self- 
evident as to seem axiomatic, except that 
it is rendered pertinent by a quotation 
from a speaker at the Richmond Conven- 
tion — that the training of nurses should 
be recognized by the hospitals as of equal 
importance with the care of the sick. 

The hospital's first duty, and really its 
only duty, is to care efficiently for the 
sick. How, is its problem. Present day 
standards require the instruction of 
nurses in caring for the sick, and, there- 
fore, there are schools for teaching 
nursing. The sole duty of these schools 
is to teach pupils how to care for the 
sick. How, is the problem of the school. 

The first, the hospital's duty, is a 
humanitarian or economic problem. The 
second, the school's duty, is an educa- 
tive problem. Two separate entities, 
closely related, perhaps, but neither one 
secondary to the other. Not until these 
two problems stand out. not for "equal," 
but for separate, distinctive consideration, 
each in its own class, and according to 
its merit, are they in position to be con- 
sidered in their relation to each other. 

We think the speaker at Richmond 
could not have been entirely oblivious of 
the distinction, but it was an unfortunate 
classification that placed the training 
school and the care of the sick in the 
same relative position ito the hospital. 
The hospital has its purpose; the school 
has its purpose — one to care for, the other 



to teach how to care for the sick. Each 
is justified in using the other just so far 
as the accomplishing its purpose necessi- 
tates, but neither may be subserved to 
the ends of the other. Neither one should 
exist for the benefit of the other. It' 
would be no more absurd to ask a hos- 
pital patient to infect himself with r.ire 
diseases that nurses might learn of them 
than to ask pupil nurses to consider their 
professional instruction complete in any 
hospital that elects to establish a school 
for, and sometimes admittedly for, tlie 
purpose of "getting its nursing done." 

We deprecate while we acknowledge 
the very general misunderstanding along 
these lines. We wish the distinction were 
more obvious. The training school's need 
does to such an extent supply the hospi- 
tal's need, and vice versa, that consider- 
ing them as complements of each other 
comes readily to the observer who sees 
the surface only. In her report on State 
Registration one delegate to the conven- 
tion said : "The great rank and file of 
nurses do not understand." We fear 
that her remark applies not only to reg- 
istration, but to nursing conditions in 
general, and not only to the rank and 
file, but to the leaders as well. What 
did the Richmond Convention accom- 
plish that stands out in refutation? The 
endowment of the Economics Course at 
Columbia, perhaps ; but it remains to be 
seen if that is accomplished. What did 
it do to clear up lack of understanding, 
to solve or help toward solution any of 
the real problems that confront the pro- 
fession's advancement? We await an 
answer. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



109 



Sound Common Sense 

In a personal letter from a nurse to 
whom we had written asking that she 
allow her name to be used to an article 
instead of her nom de plume we find 
the following: 

"To my mind your magazine stands 
for all that is best and highest in the 
nursing profession, and I really do not 
know what we would do in these days 
without its sound common sense and its 
occasional gentle reminder that the ob- 
ject of the trained nurse is still the care 
of the sick. I am quite willing to sign 
my name in hig letters to the above." In 
another letter we find: "I enjoy your 
pointed editorials, and certainly appre- 
ciate your policy in keeping your maga- 
zine to nursing.'' 

In these days of nursing fads and 
fancies, and nursing theories "run mad," 
it has taken no little moral courage and 
been no easy task to keep to our policy 
of sound common sense. 

We could not have done this without 
the support and encouragement of such 
women as those whose letters we have 
quoted and many others, notable among 
whom stands Miss Charlotte Aikens, 
whose article, "Building a Training 
School," appears in this number. Miss 
Aikens is a disciple of sound common 
sense and all her writings bear its 
stamp. In this article she turns the 
searchlight on such questions as the lack 
of method in our training schools, our 
false standards, the evils of too long a 
course of training and faulty legislation. 
The ideas expressed by Miss Aikens 
on practical nursing are much in line 
with those of Dr. Samuel W. Lambert, 
as given in a letter to the editor of the 
Alumnae News, the magazine of the 
Nurses' Alumnae Association of the 
New York Hospital. In discussing the 
changes in the training school. Dr. Lam- 



bert says : "The work of a nurse is con- 
cerned with the care of the sick and 
amounts to nothing if it is not practical, 
and I believe she has no use for knowl- 
edge, either theoretical or practical, con- 
cerning such medical subjects as "Al- 
buminuria Glycosuria indicanuria," or 
"Repair of Wounds," or "Physiology oT 
Heat Loss and Supply,'' which occupied 
equal prominence in the published cur- 
riculum of the old three years' course 
with the purely nursing subjects or 
"Care of Patients Before, During and 
After Operation," for example. 

"The argument that such theoretical 
studies do no harm even if no immedi- 
ate good results, is fallacious, for it is 
far from harmless to distract a tired 
woman from her important and useful 
work with details of elementary science 
which can be of no use to her." 

If, as Miss Aikens says, we are "hon- 
est with ourselves," we must acknowl- 
edge the soundness of the teachings of 
these disciples of common sense; but, 
unfortunately, some of the so-called 
leaders in the nursing profession will 
not be honest either with themselves or 
others. 



The Nursing of People of Moderate 
Means 

In his paper, "The Nursing of People 
of Moderate Means from the View- 
point of the Physician," which appeared 
as the leading article in the January num- 
ber, and is continued in this. Dr. Bar- 
rows presents not only his own 
views but those of some forty physi- 
cians whose co-operation he has ob- 
tained. This makes the paper of spe- 
cial value, as among those consulted we 
find the names of prominent physicians 
representing all sections of the United 
States. 



no 



THE TRAINED NURSE AND HOSPITAL REVIEW 



It will be seen that the consensus of 
opinion is that under present conditions 
it is impossible for either hospitals or 
trained nurses to provide adequately for 
this class of patients. Accepting this as 
a fact, what is the remedy? Several 
remedies are suggested by these physi- 
cians in counsel. Visiting and hourly 
nursing come in for a large share of 
approval, but the plan most in favor is 
that of trained assistants. Dr. Barrows 
believes that this plan will prevail over 
all others, and in order that these as- 
sistants shall be of the best he urges 
nurses not to scorn the movement, but 
to "lend a hand." As against the plan 
of trained assistants, many arguments 
are advanced by trained nurses, the most 
important of which is that the "assist- 
ant" will not remain an assistant, but 
will soon usurp the privileges of the 
graduate. In view of the fact that Dr. 
Barrows may be right in his assump- 
tion, however, and that the problem will 
be solved by the trained assistant, it 
makes the question one to which nurses 
should give serious thought, and not give 
a too hasty decision as to whether they 
will hinder or help. Think it over. 
+ 
Training School Discipline 

In our January editorial, in comment- 
ing on Miss Jane Addams's paper read 
before the Society of Hospital Superin- 
tendents, we spoke of the irony which 
lay beneath her calm and moderately 
put statements. We find the same 
bright gleam of polished irony in that 



very clever serial, "Extracts From the 
Journal of a Pupil Nurse," the fourth 
installment of which appears in this 
number. 

It is certainly a severe arraignment 
of our present training school methods 
when, as our "Pupil Nurse'' states, she 
must drop prejudice and devote her ener- 
gies to perfecting herself in the art of 
letting her patients wait while she takes 
time to make empty beds in the orthodox 
way, and that she shall look forward to 
reaching that degree of perfection when 
she shall be more shocked and grieved 
at sight of a disordered coverlet than on 
account of the patient whose painful 
writhing tossed it out of order. 

Miss Addams spoke from the lay- 
man's point of view, and training school 
authorities will naturally claim that she 
is prejudiced. But the "Extracts From 
the Journal of a Pupil Nurse" are from 
the pen of a graduate nurse, one who, 
though not acting in that capacity at 
present, has been one of our prominent 
superintendents of training schools, and 
so our pupil nurse is not voicing the 
opinion of the layman, but one of long 
experience in the nursing profession 
when she says : "I sometimes think there 
is just a little too much stress laid upon 
the things that count only for appear- 
ance, and not quite enough upon some 
other things that tend more directly to 
make the patient comfortable and 
happy." Another expression from the 
nurse's viewpoint will be found in our 
Inciter Box. 



Personal 



At a meeting of the Executive Committee 
of the New York Post-Graduate Medical 
School, Miss Annie M. Rykert, for several 
years matron of the hospital, was appointed 



superintendent of the Post-Graduate Hospital 
in place of Alexander H. Candlish, resigned. 
Miss Eleanor M. Brown was appointed as- 
sistant superintendent. 



In tlie Jtursms l^orlo 

ARTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATURE OR NOT, ARE CONTRIBUTED, AND 
DO NOT NECESSARILY REPRESENT THE IDEAS OR POLICY OF THIS MAGAZINE. 



New York City. 

The Commissioner of Public Charities and 
the Board of Managers of the Metropolitan 
Training School for Nurses gave a reception 
in honor of Miss Jane M. Pindell, the retiring 
Superintendent of the Metropolitan Training 
School, at the residence of Dr. and Mrs. 
Clinton L. Bagg, 24 West Forty-sixth street, 
Thursday, January 2, 1908, from 4 until 7 
o'clock. 

The nurses of the Post-Graduate School of 
Nursing of the Woman's Hospital in New 
York, gave a delightful entertainment on 
Christmas Eve to the head nurses of the in- 
stitution and others. A Christmas Tree, pret- 
tily decorated and lighted, furnished tokens 
for the class and its guests, and games, music 
and dancing were enjoyed. An excellent sup- 
per was provided, and the whole affair will 
always be remembered most pleasantly by all 
the participants. 



A meeting of the graduate nurses of Man- 
hattan and Bronx was held at the Polyclinic 
Hospital, 2x4 East Thirty-fourth street, Jan. 
6, at 4:30 o'clock. 



A meeting of the New York County So- 
ciety was held on Tuesday evening, Jan. 7, 
at Bellevue Club. 

+ 
Connecticut Notes. 

Miss May L. Love, of Norwich, a member 
of the board of examination and registration 
of nurses, has resigned. Miss Martha J. Wil- 
kinson, of Hartford, has been appointed by 
Governor Woodruff to fill the vacancy. Miss 
Wilkinson is the ablest woman in the State 
for the position to which slic has been ap- 
pointed. 

Neither the hospital nor training school su- 
perintendents are in sympathy with the recent 



raise in price by New Haven nurses. The 
New Haven Hospital refuses to pay special 
nurses over $21, and it is reported that nurses 
frorn one of the clubs active in advancing 
the price are accepting this rate from the 
hospital and rather inconsistently charging 
private families $25. 



The Graduate Nurses' Association of Con- 
necticut has fulfilled its pledge of $150 for the 
Hospital Economics Endowment fund. 



The Connecticut Training School Alumnae 
Association, though unpledged, will by indi- 
vidual subscription be able to aid the fund by 
$40. 

Miss Rose M. Heavren will go to San 
Francisco as delegate from the Connecticut 
Training School Alumnae Association to the 
Associated Alumnae convention. 



A valentine dance for Feb. 14 and a fair 
for November next are being planned to aid 
the home endowment fund of the C. T. S. 
Alumnae. 



The Graduate Nurses' Association will hold 
its quarterly meeting in Danbury, Wednesday, 
Feb. 5. 

+ 
New Orleans, La. 

The Charity Hospital Training School for 
Nurses graduated a class of twenty-six young 
women Dec. 11, 1907. The exercises were 
held in the amphitheatre of the hospital. Most 
Rev. James H. Blenk, S. M., D. D., was 
the orator of the day, and in an address 
replete with witty allusions, coupled with ear- 
nest and serious thought, he reminded the 
young nurses of the noble duties of their 
chosen profession. The Board of Administra- 
tors and tlic faculty of lecturers were well rep- 
resented at the exercises. 

Dr. E. S. Lewis, Vice President of the 



112 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Board of Administrators, opened the pro- 
gramme with a brief talk. Dr. Lewis paid 
quite a compliment to Mr. John T. Gibbons, a 
member of the Board, for having originated 
the idea which has already somewhat offset 
the difficulty of obtaining sufficient nurses. 
"It was through Mr. Gibbons' happy thought 
that the co-operation of the press was secured 
in calling attention to the need for nurses, and 
circulars to the country parishes were sent 
out. It is to this that the present large class 
can be attributed. The present class of ninety- 
nine is the largest the school has ever had. 
Even this increased number is inadequate for 
the needs of the institution, and when the 
Delgado Memorial is finished 125 will be need- 
ed. As this increase will materially add to 
the expenses of the institution, it will be nec- 
essary to petition the Legislature for an in- 
creased appropriation." 

The report of the Directress, Sister Agnes, 
was read by Dr. Batchelor. 

The diplomas and class pins were then 
awarded by Dr. Lewis to the following: 

Miss Marie Anepohl, Miss Llewellyn Benoit, 
Miss Elizabeth M. Bourg, Miss Marie B. Dan- 
iel, Miss Josephine A. Finnegan, Miss Mary C. 
Gillespie, Miss Helena H. Greve, Miss Flor- 
ence M. Hasson, Miss Cora C. Higgins, Miss 
Matilda V. Huck, Miss Julia R. Huff, Mrs. Effie 
C. Joly, Miss Mayme A. Lanius, Mrs. Carl G. 
Lewis, Miss Cecelia M. Maher, Miss Ansel- 
mus M. Mayeux, Mrs. Cecile L. Raby, Miss 
Katherine A. Renecky, Miss Bessie P. Ross, 
Mrs. Nora R. Ross, Miss Bessie B. Rosser, 
Miss Ola E. Rushing, Miss Sallie M. Sullivan, 
Mrs. Marie L. Vignau, Miss Alice E. Walker, 
Miss Alma M. Wohler. 

A dinner was given at the training school 
on Dec. 12 for the graduates of '07, the old 
graduates and house doctor. There were 
jesting and toasting and every one seemed 
happy. 

+ 
Camp Nicholas Senn. 

Feeling that those societies in which the 
greatest number have a voice and a part, 
those organized on the most democratic lines, 
are the useful and successful ones. Camp 
Nicholas Senn, at the December meeting 
amended its constitution to make the camp 
conform more nearly to this line of organiza- 
tion. The camp met in Mandel's Ivory Tea 
Room on the afternoon of December 3. After 



transacting routing business and voting to 
send flowers and a letter of sympathy to the 
secretary, Mrs. Minteer, who was unable to be 
present because of illness, the amendments, 
copies of which had been sent to the members, 
were taken up. 

As amended, the constitution makes the 
chairmen of the standing committees officers 
of the association, and provides for their 
election at the annual meeting, instead of 
being appointed by the chairman, as hereto- 
fore. In this way the Executive Committee 
is completed, thus giving the creation of the 
executive body entirely into the hands of the 
members and providing that all business not 
tran.sacted in open meeting may be done by 
the direct representatives of the membership. 

Letters on the subject were received from 
camp members in California, Toledo, Detroit 
and Peoria, approving the changes (out-of- 
town members are seldom able to attend meet- 
ings, but no meeting passes without letters 
from some of them). The action on the 
amendments was unanimously in favor of 
adoption. Plans were discussed for the con- 
vention of S. A. W. N., to be held in Chi- 
cago in June, as the guests of Camp Nicholas 
Senn, the territory of which camp extends 
from New York west to the Rocky Mountains. 
There was great rejoicing over a large check 
sent by Dr. Senn, to be used for the further- 
ance of these plans. 

I Miss Sigsbee, who has resigned her position 
in Cook County Hospital to take up work in 
a children's home in Omaha, Neb., was asked 
to act as secretary pro tem as a farewell ser- 
vice to the camp. 

While we were over the teacups before ad- 
journing Miss Jones gave a very complete 
and interesting report of the annual meeting 
of the society of S. A. W. N., which was held 
at Jamestown in October. The next meeting 
will be held Tuesday, March 3, in Mandel's 
Ivory Tea Room. A large attendance is im- 
portant. I. V. Parkes, Chairman. 
+ 
Iowa Notes. 

The new $25,000 Nurses' Home, connected 
with the Iowa Methodist Hospital, Des 
Moines, is rapidly nearing completion and will 
be ready for occupancy in a short time. The 
building is constructed of vitrified cream 
brick, is modern throughout, and will furnish 
accommodations for seventy nurses, including 



THE TRAINED NURSE AND HOSPITAL REVIEW 



113 



a large reception room and a library where 
the current literature will be gathered. The 
Des Moines home will be the largest nurses' 
training school home in the State, and of the 
twenty-two similar institutions west of Chi- 
cago, is the youngest, and is only surpassed 
in equipment and size by the Wesley Home 
in Chicago. 



The Registered Nurses' Association of Des 
Moines held its fifth annual meeting January 
3, at the Y. W. C. A. rooms, and elected offi- 
cers for the coming year. President, Miss 
Luella Bristol; first vice president. Miss Caro- 
line Lindholm; second vice president, Flora 
Patzig; secretary, Mrs. J. W. Tyrell; treasurer. 
Miss Estella Campbell ; auditor, Miss Dora 
Bunch. 



Miss Masie Blank, class of 1900, Homeo- 
pathic Hospital, spent a few days in November 
visiting old friends at the hospital. Miss Blank 
is now holding the position of Superintendent 
of the Atlantic, Iowa, Hospital. 



Miss Sarah B. Clark, class of 1905, Homeo- 
pathic Hospital, has located at No. 614 South 
Sixth street, East Cedar Rapids. 



Miss Ethel Dunham, class of 1907, Homeo- 
pathic Hospital, Iowa City, visited the hospital 
and outside friends a few days in November. 
Miss Dunham is located in her home town, 
Manchester, Iowa. 



Miss Lulu White, a graduate of one of 
Vermont's State hospitals, succeeds Miss 
Paulson as head nurse at "The Retreat," Des 
Moines, Iowa. 



Misses Anna R. Eliker and Laura G. Bob- 
enhouse, missionaries to India, are spending 
the furlough alloted them as students at the 
Iowa Methodist Hospital Training School, Des 
Moines, in order that they may be more pro- 
ficient in the work of caring for the orphan- 
ages of which they have charge in that coun- 
try. 

+ 
Fall River, Mass. 

The annual meeting of the Nurses' Alumnae 
Association was held Wednesday evening, 
Jan. I, 1908. Seven new members were en- 
rolled during the year, making a total of 



sixty-one members. Meetings, either business 
or social, have been held every month except 
September. The August meeting was held at 
the home of one of the members in the coun- 
trj' and much enjoyed. Doctors addressed the 
nurses on two occasions. It was voted to give 
assistance to nurses in sickness. The banquet 
held in December was very successful and 
much enjoyed. 

The association had a successful year, so- 
cially, financially and educationally. 

Laura W. Wood, 
Corresponding Secretary. 

+ 
Montclair, N. J. 

At a special meeting of the Mountainside 
Hospital Alumnae Association, Dec. 12, at 95 
Grove street, the following officers were 
elected for 1908: 

President — Miss K. Garrett. 

First Vice President — Miss S. A. Toole. 

Second Vice President — |Miss C. Lafferty. 

Recording Secretary — Miss A. Gutherie. 

Corresponding Secretary — Miss M. Wilier. 

Treasurer — Mrs. W. A. Mellville. 

Committee of Arrangements — Miss Annie 
Mack, chairman; Mrs. Berrian, and Misses 
Toole, Morgan and Reed. 

Visiting Committee — Miss C. Laflferty, chair- 
man; Misses Lecky and Cox. 

Auditing Committee — Miss Margaret Mack, 
chairman; Misses Robinson and Stitt. 

Nominating Committee — Miss M. Wilier, 
chairman; Misses Maines and Moore. 

M. M. WiLLER, 

Corresponding Secretary. 

+ 
Colorado Springs, Col. 

The usual monthly meeting of the Colorado 
Springs Registry Association was held in 
Grace Church Parish House on December 4. 
A most instructive and interesting lecture was 
given by Dr. Webb on "Upsonius," which was 
very much appreciated by the large number 
present. 

+ 
Philadelphia, Pa. 

The annual meeting of the Nurses' Alumnae 
Association of the Medico-Chirurgical Hos- 
pital, was Iield on December 4, in the hos- 
pital. The following officers were elected to 
serve for the ensuing year: 

President, Mrs. John L. Moyer; first vice- 



lU 



THE TRAINED NURSE AND HOSPITAL REVIEW 



president, Miss Anna Lehman; second vice- 
president, Miss Venetta V. Kahler; financial 
secretary, Mrs. William Slocum; secretary, 
Mrs. Phaon J. Rex; treasurer. Miss M. W. 
Ayres. 

One new member, Miss Shore, was admit- 
ted to the association. 

The association gave a euchre and dance on 
Friday, December 6, at 8 p. m., in the Ritten 
House, Twenty-second and Chestnut streets. It 
was well attended, and proved to be both a 
social and financial success. 

Mrs. Phaon J. Rex, Sec. 



At the end of the Fall term, 1907-1908 
twenty-five students received their diplomas 
at the Pennsylvania Orthopaedic Institute and 
School of Mechano-Therapy, Philadelphia, in 
the following branches : 

In the Swedish System of Massage, Medical 
Gymnastics, Electro- and Hydro-Therapy — 
Anna M. Deuser, San Francisco, Cal., grad- 
uate Waldeck Hospital, San Francisco, head 
nurse and later chief of same hospital, mem- 
ber Guild of St. Barnabas; Elizabeth E. Rose, 
Meadville, Pa., Meadville Hospital; Mary Ade- 
laide Vollbrecht, Erie, Pa. ; Lillian Lydia Luce, 
Haverhill, Mass. ; graduate Lynn Hospital, 
Lynn, Mass.; Juliane R. Bauer, Oberohrn, 
Germany; Maude H. Davis, Ottawa; grad- 
uate Montreal General Hospital, superintend- 
ent Red Deer Hospital, Alberta, Can., mem- 
ber Canadian Guild of St Barnabas; Dora 
Martin, Winnipeg, Manitoba, London Hospital, 
London, England, City of Dublin Hospital, 
Rotunda Hospital and Coombe Hospital, Dub- 
lin, member Australian Trained Nurses' As- 
sociation; Florence K. Gray, Portland, Me., 
New York Infirmary for Women ; Rose Cobb, 
Philadelphia; Jacob Weber, Philadelphia; 
Theodore Fleischman, Philadelphia; Jeffrey 
A. Hayes, Philadelphia. 

In the Swedish System of Massage, Gym- 
nastics and Hydro-Therapy — Margaret Aileen 
Hampton, Washington, D. C. ; A. Meretta Ride- 
out, Lynn, Mass., graduate Lynn Hospital, 
Lynn, Mass, and night supervisor of the same, 
member Guild of St. Barnabas. 

In the Swedish System of Massage and 
Gymnastics — Elizabeth Lukens, Camden, N. J. ; 
Marion J. Tewhran, New Haven, Conn. ; Clara 
Rogers, Oxford, Pa.; M. D. Billet, Philadel- 
phia; Bartie R. Bennett, Philadelphia; Martin 
P. Lawler, trainer Philadelphia Athletic Club. 



In Electro-Therapy — Margaret A. Zabel, 
Gainesville, Fla. ; graduate German Hospital, 
Philadelphia; Anna E. Livingston, Detroit, 
Mich. 

In Electro- and Hydro-Therapy — Kathryn 
Simpson, Philadelphia; Eleanor M. Wadasz, 
Philadelphia, Friends' Asylum, Frankford, Pa. 

In Hydro-Therapy — Alice E. Phillips, 
Charleston, S. C, graduate Newark City 
Hospital. 

The Winter term opens this month. 

+ 
Scranton, Pa. 
The regular monthly meeting of the Scran 
ton Training School for Nurses was held 
in the State Hospital Jan. 2, 1908. The meeting 
was called to order at 3:15 P. M. President 
Miss Alice Brice in the chair. Fairly good 
attendance. After the roll call the minutes 
of the December meeting were read and ap- 
proved. The reports of the retiring officers 
were then given. Next the election of new 
officers as follows: President, Miss Alice M. 
Brice; Vice President, Miss Charlotte Will- 
iams; Treasurer, Miss Frances Deniker; Sec- 
retary, Miss Mary Tig^ue. Miss Alice Brice 
and Miss Gibson were re-elected on the enter- 
tainment committee. Miss E. Saul and Miss 
Vandervoort on the sick committee. A vote 
of thanks was then given the retiring officers. 
A business meeting followed this. A social 
and dance will be given in February. There 
was no further business. Meeting adjourned 
to meet in State Hospital Feb. 13. 

Harriet B. Gibson, 
. Secretary. 

Camp Roosevelt. 

The January meeting of Camp Roosevelt, 
S. A. W. Nurses, was held by invitation at the 
home of Mrs. Ammerman, No. 2340 Seventh 
avenue, on Wednesday afternoon, the 8th 
inst. Mrs. Taylor presided. The illness of 
Miss Elizabeth Tuttle, of Brooklyn, was re- 
ported. Miss Tuttle is now convalescing, we 
are glad to hear. After the usual routine of 
business had been gone through, an adjourn- 
ment was made and a perfectly lovely 
"spread" was given us by our hostess. The 
February meeting of Camp Roosevelt will 
be held at Miss Edith Abrams's, No. 215 West 
127th street, on Wednesday afternoon, the 
5th. All S. A. W. nurses invited. 

Florence M. Kelly, R. N. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



115 



Toledo, Ohio. 

A free dispensary with two nurses ex- 
clusively for tuberculosis work has been suc- 
cessfully established in Toledo, Ohio. One 
of the societies which previously helped in 
the providing of district nurses has withdrawn 
from the general work and taken up this 
special tuberculosis work. The first special 
nurse began her duties in May, but already 
her field has grown so large that an assistant 
lias been engaged. Supplemental to the 
other work there will soon be opened a free 
dispensary, with a night hour and a Sunday 
hour. Some of the best known physicians in 
Toledo have volunteered their services for 
the dispensary, and a great deal of co-opera- 
tion has been secured from a half dozen 
sources. The Thalians, a woman's club, is 
financing the work. In addition to this, 
Toledo has four district nurses supported by 
the King's Daughters and the Visiting Nurses' 
Aid Society. 

+ 
Cleveland, Ohio. 

The annual business meeting of the Alum- 
nae Association of the Cleveland City Hospital 
Training School for Nurses was held at the 
Nurses' Home on Jan. 7, 1908. Thirteen mem- 
bers responded to roll call. The minutes of 
the last meeting were read and approved, fol- 
lowed by the reports from the officers who 
were present, showing the organization to be 
in splendid condition. The election of officers 
resulted as follows: President, Miss Anna 
Pepper (re-elected) ; First Vice President, 
Miss Blanche Watt; Second Vice President, 
Miss Myrtle Trappe; Secretary, Miss Emma 
Lewis; Assistant Secretary, Miss Emma Som- 
mers; Treasurer, Miss Amanda Schlobohm. 
+ 
Guelph, Ont. 

The graduating exercises of St. Joseph's 
Hospital, Guelph, took place on October 16. 
The medals and diplomas were presented by 
the Lord Bishop of Hamilton, Dr. Mackinnon 
and Mayor Newstcad, and each graduate was 
presented with a shower bouquet by the di- 
rectors of the hospital, after which addresses 
were made by his worship the Lord Bishop, 
Father Cotcc, of Hamilton; Father Donovan, 
Mayor Ncwstead, Dr. Mackinnon, Dr. Lind- 
say, Dr. W. O. Stewart and Dr. H. O. 
Howitt. The musical part of the programme 



was in charge of Mrs. Kennedy. The grad- 
uates were Miss Bush, St. Clements; Miss 
Myers, Waterloo; Mrs. Hanlon, Guelph; Miss 
Cooper, Gait; Miss Toner, Hamilton. 

+ 
Orange, N. J. 

The Orange Branch, Guild of St. Barnabus, 
held its monthly meeting for November on 
Thursday, the 21st, at Christ's Church, 
East Orange. Owing, probably, to the day 
being a severe stormy one there was but a 
scanty attendance. 

A helpful sermon was preached, in which 
^he speaker took for his text Christ's message, 
"Peace, I Give Unto You." The preacher ex- 
plained that Christ had peace within Himself, 
and that although surrounded by much which 
made for disturbance and turmoil, neverthe- 
less our Saviour was always at peace. 

The usual collection for the sick relief fund 
was taken, and at the close of the church 
service those present assembled in the choir 
room for business meeting. Chaplain in the 
chair. 

Routine business followed, after which the 
secretary, Mrs. Howe, announced that the or- 
ganization known as the Committee on Fresh 
Air Work in the Oranges, had, after much de- 
liberation, purchased a parcel of ground con- 
taining a small house at Bradley Beach, New 
Jersey. The price of purchase was $3,000, 
but the greater portion of the price was to 
remain as mortgage. 

Moved and carried that the Guild hold an 
apron sale some time during the winter, pro- 
ceeds of which would be used toward furnish- 
ing the room for the nurse at this Bradley 
Beach cottage. 

At the adjournment of the meeting coflfee 
and cake were served and a pleasant social 
time ensued. 

+ 
Married. 

Married, at the home of the bride's parents, 
in Algona, Iowa, December 31, Miss Bertha 
Heise to Dr. E. Arent, of Humbolt, Iowa. 
Miss Heise is an efficient and popular trained 
nurse of Algona, and Dr. Arent one of the 
best known physicians in Humbolt County. 



Miss Edith Hoover, for five years superin- 
tendent of the Herschey Hospital, of Musca- 
tine, Iowa, was wedded on the evening of 
December 25 to the Rev. Arthur E. Ryan. 



116 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Mr. and Mrs. Ryan will leave about April ist 
for Mastovan, Turkey, in Asia, where they 
will become Congregational missionaries. Both 
are well known young people of Muscatine 
and belong to prominent Iowa families. 



At Newburgh, November 27, Miss Ella Bier- 
man to Dr. Percy Banks, of Coldenham, N. 
Y. Mrs. Banks is a graduate of St. Luke's 
Hospital, Newburgh, class '06. 



Married, by the Rev. John Paulson, at the 
residence of the bride's parents, in Henning, 
Minn,. November 28th, Miss Josephine Paul- 
son and Mr. Nelson Swcnersen. At home in 
Orthey, S. D., after December 15. Mrs. Swen- 
crsen is a graduate of the Iowa State Hos- 
pital Training School, Independence, Iowa, 
and for some time had held the position of 
chief nurse at Dr. Hill's Retreat, Des Moines, 
Iowa. 



Announcement December 17th, of the mar- 
riage of Miss Carolyn Paulson, late superin- 
tendent of nurses at the Iowa Soldiers' Hospi- 
tal, Marshalltown, Iowa, to Mr. Harris A. 
Newell, of the same city, will cause much sur- 
prise to the many hospital friends of Miss 
Paulson throughout the State, who expected 
her return to the hospital after a three months' 
leave of absence, which was granted November 
15th. The announcement reads as follows: 
"Married, in Chicago, June 23d, 1907, by the 
Rev. Dr. Peirce, of the Methodist Episcopal 
Church, Miss Carolyn Paulson and Harris A. 
Newell, of Marshalltown. Mr. and Mrs. New 
ell are residing in Chicago, where the former 
is finishing a course in medicine at North- 
western University Medical College. They 
are at home at 2520 Indiana avenue." 



Married, at the Church of the Ascension, 
Bradford, Pa., Thursday, Nov. 28, 1907, Elea- 
nor Alice Partridge, of Bradford, to H. Edwin 
Brown, of Ossining, N. Y. Mrs. Brown is a 
graduate of the Philadelphia Hospital Training 
School, class 1899. Mr. and Mrs. Brown will 
bs at home to their friends after February ist, 
1908, at 19 South Malcolm street, Ossining-on- 
the-Hudson. , 

+ 
Personal. 

Miss Lillian Lydia Luce, of Haverhill, 
Mass., a graduate of the Lynn Hospital, Lynn, 



Mass., after completing a course in the Swed- 
ish system of massage, gymnastic, electro 
and hydro therapy at the Pennsylvania Or- 
thopaedic Institute and School of Mechano- 
Therapy, Philadelphia, has been placed in 
charge of the bath and massage department 
at the Alcazar Hotel, at St. Augustine, Fla. 



i 



Mr. John M. Bornmann, a graduate of the 
Pennsylvania Orthopaedic Institute and School 
of Mechano-Therapy, Philadelphia, in the 
Swedish system of massage, gymnastics and 
hydro-therapy, has been placed in charge of 
the male department in massage at the nervous 
clinic of the Medico-Chirurgical Hospital in 
Philadelphia. 



Miss Amy McCreery, a graduate in me- 
chano-therapy of the Pennsylvania Ortho- 
paedic Institute and School of Mechano- 
Therapy, Philadelphia, has been engaged by 
the department of mechano-therapy of the 
Lakewood Hotel, Lakewood, N. J. 



Miss Jane M. Pindell will succeed Miss 
Gilmour as superintendent of the New York 
City Training School for Nurses. Miss Ward 
will succeed Miss Pindell at the Metropolitan 
Training School. 



Miss Olive Helen Eames, of San Diego, 
Cal., a graduate nurse of the San Diego 
County and General Hospital, and in charge 
of the mechanical department of the Agnew 
Sanitarium in San Diego, after taking a course 
in the Swedish system of massage, medical 
and orthopaedic gymnastics, electro and hydro 
therapy at the Pennsylvania Orthopaedic In- 
stitute and School of Mechano-Therapy, Phil- 
adelphia, has been appointed department su- 
perintendent of the Agnew Sanitarium. 



Miss Rose Enge was elected superintendent 
of the Ramsey County Nurses* Association at 
a special meeting held at the club rooms, 
Lowry Arcade. She succeeds the late Miss 
Ida Sweatman. 



Miss Marilla Williams, who for eight years 
was superintendent of the Deaconess Hos- 
pital, Jeffersonville, Ind., but who left a couple 
of months ago for a visit with her parents at 
Storm Lake, Iowa, where she went for the 
purpose of getting a rest and to recuperate after 



THE TRAINED NURSE AND HOSPITAL REVIEW 



117 



an attack of typhoid fever, has now been 
elected superintendent of the Methodist Epis- 
copal Hospital at Indianapolis, and her friends 
received the news of her election with much 
pleasure. 



Sister Theresa, a nurse at St. Mary's Hos- 
pital, Milwaukee, Wis., was shot and killed 
by Gustav Wirth, who is believed to be in- 
sane. The assassin was captured after being 
chased several blocks. Wirth was operated 
upon at the hospital a year ago. He called 
there, and, upon seeing Sister Theresa, began 
a fusilade, firing four shots into her body. 
Sister Theresa died in a few minutes. Wirth 
said the hospital officials had tried to poison 
him. 



Miss Crawford, who has been acting super- 
intendent of Framingham (Mass.) hospital 
since Dr. Hintze retired, has tendered her 
resignation, to take effect March i. 



The alumnae of the New York City 
Training School have opened a clubhouse and 
registry at 1185 Lexington avenue, where 
Miss Irene B. Yocum, the Registrar, will ex- 
tend a hearty welcome to all friends. 



Miss F. Elizabeth Hill, who was night su- 
perintendent of the Philadelphia Orthopedic 
Hospital and Infirmary for Nervous Diseases, 
has taken charge of the Cottage Hospital of 
Portsmouth, N. H., as superintendent, to suc- 
ceed Miss Anna F. Alpaugh, who was mar- 
ried December 18, 1907, to Dr. Blaisdell, of 
Portsmouth, N. H. Miss Hill is a graduate 
of the City Hospital of Williamsport, Pa. 



Obituary. 

It is with deep regret that the Alumnae 
Association of Sherman Hospital, Elgin, 111., 
learned of the death of Miss Jennie Ilaver- 
kampf at the hospital at Lawrence, Kan., 
December 28, 1907, of typhoid fever. Miss 
Havcrkampf was a graduate of the class of 
1905 of Sherman Hospital. The following 
resolutions were adopted : 

Whereas, Our Heavenly Father has deemed 
il best to remove from us our concientious 
sister, Jennie Havcrkampf; be it 

Resolved, That we, the Alumnae Associa- 



tion of Sherman Hospital, extend to the fam- 
ily of Miss Havcrkampf our sympathy; and 
bo it further 

Resolved, That a copy of these resolutions 
be sent to her family, the nursing magazines, 
and that they be spread upon the records of 
our association. 

Florence Wenegar, 
Esther Bishop, 
Kathleen Mitchel. 



Mrs. Albert C. Odell died on Sunday eve- 
ning, November 11, at 6 o'clock, at her home, 
437 First street, Brooklyn. Mrs. Odell had 
been ill for three weeks with typhoid fever. 

Mrs. Odell was a graduate nurse of St. 
Luke's Hospital, Newburg, N. Y. She was a 
native of Sarnia, Ontario, Canada. She was 
a daughter of Mr. and Mrs. C. E. Proctor. 
Her sister. Miss Ida, was with her when she 
died, she having been summoned from De- 
troit. 

Mrs. Odell was an estimable young woman 
and her death will be sincerely mourned by 
her many friends in Newburgh. 



Miss Bertha H. Harris, graduate of the 
Maine Eye and Ear Infirmary Training 
School, class of '96, died quite suddenly No- 
vember 25th, 1907, at her home in Portland, 
Me., after a brief illness. 

At the December meeting of the Alumnae 
Association of the Maine Eye and Ear In- 
firmary Training School of Nurses the fol- 
lowing resolutions were adopted : 

Whereas, It has pleased God in His all wise 
providence to remove from our midst Bertha 
Holmes Harris, class of '96. 

Resolved, That we, the members of the 
Alumnae Association, have sustained in her 
death the loss of a valued friend and loyal 
member, and that we tender to her mother 
and sister our sincere sympathy. 

Resolved, That a copy of these resolutions 
be sent to her family, to The Trained Nurse, 
The Journal of Nursing and be recorded 
on the minutes of the association. 
Committee on resolutions, 

Marie C. Stover, 
Minnie Tibbetts, 
Ada L. Knight. 
Portland, Me., December 15th, 1907. 



(Continued on page 122.') 



Clje CUitor's Itttn-box 

THE EDITOR IS NOT RESPONSIBLE FOR THE VIEWS OF CONTRIBUTORS. CONTRIBUTIONS FOR THIS 
DEPARTMENT MUST BE ACCOMPANIED BY THE NAME AND ADDRESS OF THE SENDER, NOT 
NECESSARILY FOR PUBLICATION, BUT FOR THE USE OF THE EDITOR. 



To Our Contributors. 

We must again call attention to the fact 
tliat letters intended for this department must 
be accompanied by the name and address of 
the sender. This is for the use of the editor 
only. We have received a number of inter- 
esting letters, to which we will be glad to 
give attention when the above conditions are 
complied with. 

+ 
How Much Shall We Teacht 
To the Editor of The Trained Nurse: 

The modern, busy physician and surgeon, 
whose time is necessarily limited to the 
weightier problems of his profession, has 
been forced to realize the necessity of a re- 
liable assistant. Hence the nurse. 

The assistant who must share with the 
surgeon his tremendous responsibilities must 
have a thorough understanding of her profes- 
sion, and the more general, the wider will be 
her range of usefulness. It has been said 
that to know one thing well one must know 
everything. We do not even aspire to that 
height of perfection; however, knowledge is 
always a valuable possession. If a little 
knowledge is dangerous, then who is out of 
danger? Some of the views recently ex- 
pressed in the nursing journals regarding the 
"higher education of nurses" have evidently 
been made by some whose advantages have 
not, unfortunately, been a "higher education." 
No right-minded person can say that educa- 
tion or development of the mind unfits a 
nurse for her profession. This fact is proved 
by the quality of women holding responsible 
positions as nurses in the various institutions 
and associations. The uneducated and ill- 
bred make up that class largely which causes 
discord and lack of harmony among nurses. 

A prejudice against the instruction of 
nurses has been entertained by some of the 
medical profession, who feared that the nurse 
would trench upon their own province. It is 



only those who have no formal instruction as 
to their duty who will overstep the bounds of 
propriety. The trouble with such nurses is 
not that they know too much, but that they 
know too little. 

The facts are also proven by a well-known 
surgeon. Dr. William Rawlings, who is chief 
surgeon of Rawlings's Sanitarium, of Sanders- 
ville, Ga., who has added, as a part of the 
regular three years' course of training, a six 
months' course of instruction in the adminis- 
tration of anesthetics — the instruction con- 
sisting of lectures, demonstrations and actual 
practice under the instructions of Dr. H. A. 
Hermann. From 150 to 200 general and local 
anesthetics are given in that time. The anes- 
thetics given embrace all those used in the 
modern practice of surgeons, viz., ether, chlo- 
roform, nitrous oxide gas, cocaine and their 
various modifications. 

A special course of two months in dietetics 
has also recently been added. The instruc- 
tion is given by a nurse especially trained at 
a prominent cooking school in Boston, Mass. 

The human mind, with its rare capacity for 
cultivation and development, should never be 
content, but, like the immortal Oliver, con- 
stantly call for "more." 

Marion Whitten, 
Superintendent of Nurses. 
+ 
Infant Training and Feeding. 
To the Editor of The Trained Nurse: 

"The Often Perplexed Nurse," in the De- 
cember number, states my idea exactly. I 
have read with great interest the articles writ- 
ten by Miss Harrison and Miss Harris, and 
often wished obstetric nurses would give their 
views on infant feeding and training through 
the Trained Nurse. I cannot get a baby to 
sleep from 10 p. m. till 6 a. m. without food, 
no matter how I try, and how can we, in pri- 
vate practice, leave the little ones scream dur- 
ing the night. I have pacified some wee babies 



I 



THE TRAINED NURSE AND HOSPITAL REVIEW 



119 



with warm water from a bottle, but where I 
have a healthy cliild with strong lungs, and a 
hearty feeder, it would awaken the neighbor 
hood. A hungry child will not be pacified 
until fed. 

I have no trouble during the day time, for 
where the infant is not satisfied after the 
second week with the contents of the breast, I 
give two ounces of prepared top milk after 
each nursing. I have no trouble with bottle- 
fed babies. I give each child the food accord- 
ing to its own capacity, and then it is satis- 
fied; I change according to the wants of the 
child, not according to age, or text book. But 
the night feeding is where I find the trouble. 
How about other obstetric nurses in private 
practice? Would be pleased if this subject 
would 'be taken up through the Trained 
Nurse. Etta F. Gratzner, 

Ten Years, Obstetric Nurse. 

+ 
Getting the Baby to Sleep. 

To the Editor of The Trained Nurse: 

In answer to an often perplexed nurse, I 
will tell what I do to get my babies to sleep 
all night. She asks, "What is to be done when 
a baby wakes in an hour's time?" Surely you 
wouldn't feed it again? If so, I am sure 
there would be trouble. If a baby wakes in 
an hour after having a good meal it is not be- 
cause it is hungry, but may be from several 
reasons. You want to be sure it has had a 
good meal, though, and not too much or too 
little, for overfeeding or underfeeding would 
cause it to wake (although Dr. Page says a 
baby never cries because it is hungry, as hun- 
ger is not a pain), and if a baby wants to 
nurse forty minutes you may be sure it is one 
of the two, for when there is sufficient milk 
ten, or not more than fifteen, minutes on each 
side is long enough for any baby. I have 
never had much trouble that way myself for 
I find when there is a good supply of milk my 
babies are satisfied in fifteen or twenty min- 
utes. And if they are not satisfied I give the 
bottle for one feeding, or after they have 
nursed ten minutes on each side. And if they 
want it then I feel pretty sure the mother has 
not enough, or it is not the "right kind." If 
a baby is getting enough to eat, you will not 
have much trouble training it to sleep all 
night. If a baby gains right along at the rate 
of three or four ounces a week, it is getting 
enough to eat. Text books only give the 



amount for two hour feedings, and I find 
babies who are only fed six times in the 
twenty-four hours from the first can some- 
times take twice the amount set down in text 
books without any discomfort. I begin by giv- 
ing one meal in the night after 9 or 10 p. m., 
about 2 a. m. (never before), then gradually 
make the time a little longer, until at the 
fifth or sixth '<■ week the night feeding is 
dropped. Some babies drop the night feeding 
themselves, and begin to sleep right through, 
at six or seven weeks, from 6 p. m. until 6 
a. m. Others will wake and cry for a while. 
I see that they are dry and comfortable, and 
if they have been sleeping on the right side, 
turn them on the left. Sometimes just doing 
that will quiet them, and sometimes they cry 
fifteen or twenty minutes before they go to 
sleep. I never give water in the night, for 
unless a baby has a pain it does not need it, 
and that only gets it into the habit of want- 
ing something. When a baby sleeps from 6 
p. m. until 6 a. m., just before I retire I make 
sure it is dry and turn it on the side it has 
not been sleeping on all evening. Do it gently 
and the baby will not wake up, or if it does 
will go right to sleep again. Sometimes it 
takes patience to get a baby to sleep all night, 
but the results are so good and it is so much 
easier to do it when they are very young than 
to wait until they are ten or twelve months 
old, that I think you will find your patients 
as grateful as mine have been when I have 
left them such good healthy babies. 

Annie L. P. Harrison. 
+ 
An Open Letter. 
Tg the Editor of The Trained Nurse: 

Will you kindly insert the following in your 
journal, giving it as prominent place as pos- 
sible ? 

The writer desires information regarding 
any alleged recoveries or cures of inoperable 
or recurrent carcinoma of the mammary gland. 

If any case or cases are known to any one 
who reads this circular and can be authenti- 
cated by facts as to the history and condition 
prior to recovery and the length of time which 
has elapsed since recovery, such information 
will be much appreciated and duly acknowl- 
edged.- 

Any well-authenticated reports of recoveries 
from carcinoma located in other parts than 
the mammary gland will be welcomed. 



120 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Cancer ■ paste cures, X-ray cures, radium 
cures, or cures as result of surgical operation 
are not wanted. 

Hearsay cases are not wanted unless accom- 
panied by name and address of person who 
may give knowledge first hand. Address 
Horace Packard, 
470 Commonwealth Avenue, 
Boston, Mass. 
December 30, 1907. 

+ 
Shall We Sell Nursing? 
To the Editor of The Trained Nurse: 

Is "The Independent Nurse," whose letter 
appeared in the January issue of The 
Trained Nurse, quite justified, ethically or 
professionally, in the stand she takes? As 
members of a profession, we owe allegiance 
to the tenets and customs of that profession. 
We cannot afford to be iconoclasts. The ruth- 
less destroyer of professional ideals and stand- 
ards of conduct will scatter abroad as much 
trouble as of old did the "tcarer down of 
idols." As a profession, doing "work for the 
work's sake," nursing is a high, ennobling, hu- 
manitarian occupation; as a "commodity on 
the market" it will be relegated to the grade 
of personal service and the nurse will become 
a menial. 

If a member of our profession elects to 
become a "free lance," conforming only to such 
conventions of professional conduct as appeal 
to her as an individual — setting up an inde- 
pendent ethical code, which, according to her 
logic, will work against her if it isn't right- 
she is doing incalculable harm to the profes- 
sion of which she "elected" to become a mem- 
ber. While she stands as a member of the 
profession her deeds react and reflect on the 
profession. The example of her deed as well 
as the deed itself has a far reaching influence 
over which she has no control. Every deed 
docs react, but not necessarily at once or on 
the doer. A deed done as an individual and 
a deed done as the representative of a cor- 
porate body have different effect and signifi- 
cance. 

The care of the sick is the reason for and 
the purpose of our profession's existence. The 
individual members have a duty to the pro- 
fession. The professional conscience requires 
of the individual the fulfilment of the pro- 
fession's purport. 

A profession is a vocation requiring special 



fitness and preparation ; it is studied and prac- 
tised for a definite end other than the personal 
benefit of the professor. 

A trade is an exchange of equivalent values ; 
a means of livelihood; service exchanged for 
monetary consideration. 

If nursing is a "commodity on the market;" 
if the relief of sickness and suffering is a 
supply to meet a demand in the conmiercial 
sense; if nursing is merely a means of liveli- 
hood; if a woman chooses nursing as licr 
work from no other motive than she chooses 
stenography or a department store clerksliip; 
if patients are merely a material for our 
wage-earning labor, then nursing is a trade, 
an occupation, and not a profession. 

One does not need to be a sentimentalist to 
appreciate this distinctive quality which "The 
Independent Nurse" ignores. It is simply the 
difference between the humanitarian and the 
hard-headed tradesman; the philanthropist 
and the doctrine of the weakest to the wall. 

The profession needs the help of every one 
of its members. In the perfectness of its com- 
ponent parts is the perfectness of the whole. 
We are in a state of politics and trial of new 
things from ^hich we shall emerge made bet- 
ter or worse by the interpretation of what 
nursing truly is to be. Can "The Independent 
Nurse" afford to put it on a purely commercial 
material basis? 

Shall we profess nursing or shall we sell 
nursing? 
One Who Desires To Be a Professional 

Nurse. . 

Agrees with Miss Addams. 

To the Editor of The Trained Nurse: 

I wish to thank Miss Jane Addams through 
you for the paper "The Layman's View of 
Hospital Work Among the Poor." It is not 
only the poor, but many times those who are 
blessed with money, who suffer as she has 
described. 

In 1895 I was a patient in a Sisters of Char- 
ity Hospital in Colorado. I paid well for my 
care, but there were many who paid nothing. 
I was so pleased with their work that when I 
recovered I entered a hospital and trained for 
a nurse. Since then I have had three very 
severe operations. Once I was in a private 
hospital, and twice in one of our best general 
hospitals. Although I had a special nurse 
and paid high for my care, yet many times 
I wished for my Sister of Charity. 



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W Jen I was receiving my nurse's training course 
in Denver, the nurses were compelled to wear rubber 
heels while on duty. The pittance we received with 
our training barely kept us in uniforms, and it was 
necessary we should economize in every possible 
manner. For some time I used cheap rubber heels, 
but I soon found the shoes would scarcely be worn 
until the heel would be completely worn out. My 
dealer advised me to have the O'SuIlivan put on 
my shoes. They wore three times as long, conse- 
quently were cheaper. They were more comfortable 
because they were more elastic than the other 
cheaper beefs. I informed the other nurses of them 
and It was not long until we used no other rubber 
heel but O'SulUvan'e. MRS. JAMES A. ARMOUR, 
Alliance, Neb. 

O'SULLIVAN RUBBER CO., ^SaIs.' 



\VIicu you write Advertisers, please mcnllou TnK Thained Nuksb. 



122 



THE TRAINED NURSE AND HOSPITAL REVIEW 



I shall never forget one night I was suf- 
fering great pain, and begged my nurse for 
something hot. She said I ought to expect 
the pain after such an operation, and she 
thought a nurse should have more reason. 
Many mornings I was tired after a sleepless 
night; but never mind, the room must be put 
ill order, and I dressed for the doctors' call, 
and after the call I was too nervous to sleep. 
It is doubtful whether I am ever strong 
enough to nurse again, but if I am, my pa- 
tients will not have the many so-called hos- 
pital blessings. 

A Reader of The Trained Nurse. 

+ 
Have You Had a Like Experience? 

To the Editor of The Trained Nurse: 

I wish to submit to our magazine a strange 
obstetrical case which was under my care. A 
male child born November 12. Delivery nor- 
mal. Mother did well. Child did well until 



about one week after delivery. Then the skin 
of the right forefinger loosened at the nail 
and came off. Same on thumb of other hand. 
This trouble spread all over the body, the skin 
coming off in different places. Head and eyes 
affected. Digestion not good. Treatment for 
indigestion and skin affection. Bichloride bath 
and olive oil changed to boric acid when new 
skin formed. Child died two days before it 
was three weeks old. After death, skin over 
face was like parchment, drawn and broken 
in places, showing little fine capillaries. This 
was the mother's third child. The second 
child had the same malady as this babe. The 
skin peeled and she was troubled with indi- 
gestion for two months, but is now an ap- 
parently healthy child. The undertaker said 
he had never seen such a case. The physician 
in attendance had a record of 1500 deliveries, 
but fiever a child like this. Has any nurse had 
a like experience? 

A Nurse of the Middle West. 






3n tilt jaursing SBHorlti 



■Continued 



Personal. 

Mr. and Mrs. Verson M. Boothby, regis- 
tered nurses, of Lebanon, Conn., have accepted 
the positions of superintendent and matron 
of a sanitarium at Woodmont, Conn. 



Miss Elizabeth E. Heinemann has been 
elected to succeed Miss Rodgers at the Emer- 
gency Hospital, Nashua, N. H. Miss Heine- 
mann has been serving in the capacity of as- 
sistant matron for the past two years. 



Miss Margaret Bayle succeeds Miss Heine- 
mann as assistant matron at the Emergency 
Hospital, Nashau, N. H. Miss Baylc is a 
graduate of last year's class at the Emergency 
Hospital. 



Miss Mary B. Cornell, who for the past 
year has been in charge of the tuberculosis 
dispensary, Wilkesbarre, Pa., but resigned 
some time ago, left for her home in Phila- 
delpliia, from where she expects to take up a 



position of the same nature. It is most sin- 
cerely regretted by all that Miss Cornell 
should have resigned just at a time when the 
fruit of her hard, earnest labor is about re- 
alized. Too much cannot be said of the ex- 
cellent manner in which Miss Cornell carried 
on the management of the dispensary, but the 
results obtained speak for themselves. Dur- 
ing her stay in Wilkesbarre she made many 
friends, who, with her patients, were loath to 
have her leave, and who wish her every suc- 
cess and happiness in her new position. 



Miss F. L. Croft, superintendent of the 
Virginia Hospital, has tendered her resigna- 
tion, to take effect January 15. She will be- 
come assistant superintendent of the New 
York City Hospital Training School, from 
which she was graduated. Miss Croft has 
been superintendent of the Virginia Hospital 
for the past two years, and during that time 
has made a most efficient officer. Her de- 
parture from Richmond will be viewed with 
sincere regret. 



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Diseases of Children for Nurses, Including 
Infant Feeding, Therapeutic Measures Em- 
ployed in Childhood^ Treatment for Emer- 
gencies, Prophylaxis, Hygiene and Nursing, 
by Robert S. McCombs, M. D., assistant phy- 
sician to the dispensary and instructor of 
nurses at the Children's Hospital of Phila- 
delphia ; assistant physician to the medical 
dispensary of the Hospital of the University 
of Pennsylvania. Illustrated. i2mo of 430 
pages. Price $2.00. For sale by the Lakeside 
Publishing Company. 

The author's experience in lecturing to 
nurses at the Children's Hospital of Phila- 
delphia convinced him of the necessity 
of a book dealing with the various ques- 
tions of sickness and disease found in 
infancy and childhood, and which the nurse 
is called upon often to manage. This volume 
is written from the standpoint of the nurse, 
and the author has emphasized just those 
points that nurses most need to know. The 
various diseases of the respiratory and of the 
digestive tract; of the circulatory system, of 
the nervous system, of the urinary tract, as 
well as of diseases of the eye, ear, skin and 
glandular system, together with infectious 
fevers, typhoid fever, tuberculosis, contagious 
diseases, constitutional and nutritional dis- 
eases are each described in a short but concise 
manner, enabling at once the nurse to know 
what symptoms to expect and what complica- 
tions to guard against in each disease. Sep- 
arate chapters are given also to peculiarities 
of children's diseases, nursing in childhood, 
infant feeding and artificial feeding. A brief 
chapter on therapeutics gives the limitation of 
drug giving in childhood, as well as the ac- 
tion characteristic to those drugs most com- 
monly used. This chapter contains also treat- 
ment in emergencies, as well measures em- 
ployed to reduce temperature, for counter- 
irritation, for baths, etc. Chapter XX. con- 
denses weights and measures and abbrevia- 
tions, and Chapter XXI. gives a brief but 
complete medical terminology and glossary. 
The index is complete and satisfactory. 



There are 116 illustrations distributed through- 
out the text, each making clear some particu- 
lar part of the work. Many of these figures 
are colored. The volume is well bound in 
dark green cloth and of a convenient size to 
handle. This book presents in a most prac- 
tical manner, the subject suggested by its 
title, and will, we believe, win great favor as 
a ready book of reference and instruction for 
nurses. 



A Manual of the Practice of Medicine, by 
A. A. Stevens, A. M., M. D., professor of 
therapeutics and clinical medicine in the 
Woman's Medical College of Pennsylvania. 
Eighth edition, revised. i2mo, of 558 pages, 
illustrated. Flexible leather, $2.50 (net). 
For sale by the Lakeside Publishing Company. 

The author is very happy in the expression 
with which he opens the preface of the first 
edition. He quotes from Pope to the effect 
that 

"Half our knowledge wc must 
snatch, not take," 
and continues: "If this be true of general 
knowledge, it is certainly true of the knowl- 
edge of medicine as it is taught in the schools 
of to-day. In view of this fact, there seems 
to be a real need for books which present 
their subjects in an assimilable form." 

It is a coincidence that it was in our Janu- 
arj', 1907, number that we reviewed the sev- 
enth edition of this work, and the fact that 
an eighth edition was necessary within a year 
is sufficient testimony to the value of the 
work. 

As to the work itself, we cannot do better 
than to practically repeat what we said in re- 
viewing the seventh edition. This work is 
prepared for students with an idea of giving 
the most essential facts in the most condensed 
space possible. The author has achieved the 
happy faculty of saying what he has to say in 
the small space at his disposal, as if it were 
all the space he needed and more would be 
superfluous. The book can be safely recom- 
mended to all students of medicine. 



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When jon write AdTertiscrs, please mention Thb Trained Ndbsx. 



126 



THE TRAINED NURSE AND HOSPITAL REVIEW 



A Text-Book of Physiology, by Isaac Ott, 
A. M., M. D., Professor of Physiology in the 
Medico-Chirurgical College of Philadelphia. 
Second revised edition. Illustrated with 393 
half-tone engravings, many in colors. Royal 
octavo, 815 pages. Bound in extra cloth. 
Price, $3.50, net. For sale by Lakeside Pub- 
lishing Company. 

This book, just out, is the latest work on 
physiologj-. ' It is a thoroughly modern ele- 
mentary, and at the same time comprehensive 
manual of physiology. As the first edition of 
this work placed it immediately in the first 
rank of well-known text-books on physiology, 
it would be a work of supererogation to do 
more than mention in what the second edition 
is an improvement upon the first. 

More than 250 engravings have been added; 
several are full-page plates, and a large num- 
ber in colors. The number of pages has been 
increased from 560 to 815. The whole work 
has been most carefully revised by the au- 
thor and every chapter brought up to date. 
This necessitated that many of them should 
be much extended, as has been done in the 
case of Electro-Physiology and the Sympa- 
thetic Nervous System. 

To mention every improvement would be to 
give an extended and careful review of the 
work, for which, unfortunately, we have not 



the space. But we can sum up by saying that 
we believe this work will be found the fullest 
presentation of the latest facts in the science 
of physiology. 

+ 

We have received and beg to acknowledge 
the following books, which we regret lack of 
time prevents us from reviewing in this issue : 

Bacteriology in a Nutshell, a Primer for 
Junior Nurses, by Miss Mary E. Reid, grad- 
uate nurse, late superintendent Thomas's Hos- 
pital Training School for Nurses, Charleston, 
W. Va., and late superintendent of nurses, 
Charleston General Hospital, Charleston, W. 
Va., 1905-1907. Revised and enlarged. Price, 
55 cents. 

The Good Neighbor in the Modern City, by 
Miss Mary E. Richmond, author of "Friendly 
Visiting Among the Poor," general secretary 
of the Philadelphia Society for Organizing 
Charity. Price, 60 cents. A book for visiting 
nurses. 

A Manual of Medical Jurisprudence, Insan- 
ity and Toxicology, by Henry C. Chapman, 
M. D., professor of institutes of medicine and 
medical jurisprudence in the Jefferson Medi- 
cal College of Philadelphia, etc., etc. Third 
edition, thoroughly revised, with sixty-four il- 
lustrations and four plates in colors. Price, 
$I75. 



Honors for Florence Nightingale. 



The insignia of the Order of Merit was, by 
command of His Majesty King Edward VII., 
conveyed recently to Miss Florence Nightin- 
gale at her residence, by Colonel Sir Douglas 
Dawson, the registrar and secretary of the 
Central Chancery of the Orders of Knighthood. 
A message of thanks was sent to the King. 
"Miss Nightingale is deeply touched by His 
Majesty's gracious thought in giving her the 
Order of Merit, and by the great honor done 
her in associating her name with those of the 



distinguished men who have already received 
it." 

During his stay in London the German Em- 
peror paid a very graceful compliment to Miss 
Nightingale. He purchased a bouquet and 
sent it to her, accompanied by a letter express- 
ing his esteem for her great services to hu- 
manity. - In directly doing honor to the pioneer 
of trained nursing, the German Emperor has 
indirectly done honor to the nursing profes- 
sion. — Nursing Mirror, London. 




ADVERTISEMENTS 






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- ".^^•~'***-«, . 



C7»v 



Piiuline Ah{H* 



'^PC} 



Wh.ea you writ*; Advertisers, pleaHe mention Thh Tbaineq Nubse. 



CI)e ^odpttal MtW\si 



Christmas at Iowa's State Hospitals. 

Christmas exercises were lield at all of the 
State hospitals of Iowa and excellent dinners 
served to the patients. Presents from relatives 
were delivered through the medium of Christ- 
mas trees or by other methods of arrange- 
ments. Several had very interesting pro- 
grammes. The following exercises were held : 
Mt. Pleasant Hospital. 

Wednesday evening, December 25, distribu- 
tion of gifts. Part i — Concert by the hos- 
pital orchestra. Part 2 — A visit by the pa- 
tients to the following booths, which were 
prettily decorated, and from which a treat 
was given to every patient: Candy booth, nut 
booth, lemonade booth, apple booth, orange 
lx)oth, pop-corn booth and sandwich booth. 
Part 3 — A visit to Dr. Emrich's world re- 
nowned side show, which afforded much 
amusement both to patients and employees. 
Cherokee Hospital Programme. 

Friday, December 20 — 'Patients' ball. De- 
cember 23 — Entertainment given by patients. 
December 25, 2.30 P. M. — Music on wars by 
hospital orchestra; distribution of gifts. 
December 26 — Masque ball. December 27 — 
Orchestra concert. December 30 — Patients' 
social. December 31 — Employees' ball. Janu- 
ary 2 — Stereopticon entertainment. January 
3— Patients' ball. 

At Independence and Clarinda hospitals the 
dining rooms were trimmed with Christmas 
greens and bountiful dinners were served to 
all. The entertainment was on a similar scale 
as the others given above. 



Iowa Soldiers Home Opens New Addition. 

The $30,000 addition erected the past 
summer at the Iowa Soldiers' Home Hospi- 
tal, Marshalltown, Iowa, has lately been 
opened^for the reception of patients. The new 
addition affords much needed room and is 
finely finished in oak and very neatly fur- 
nished. It is built of red pressed brick, has 
two stories and basement, contains four wards, 
sixteen private rooms, two sitting rooms, two 
sets of baths and toilet rooms, two suits of 



three rooms each, for the use of the assistant 
surgeon and superintendent of nurses. It is 
finely ventilated, heated and lighted, and up- 
to-date in all particulars. The institution is 
now the finest of all the hospitals proper belong- 
ing to Iowa's State institutions. The whole 
building now contains fourteen wards, twen- 
ty private rooms, six day rooms, public re- 
ception room, five sets of baths and lavatories, 
fine operating room, with X-ray and anesthetic 
rooms in connection, and a well supplied gen- 
eral dispensary that furnishes medical sup- 
plies for the full nine hundred inmates of the 
Home, commodious trunk and clothes rooms, 
hospital supply and drug rooms, store rooms 
and cold storage and two morgues occupy dif- 
ferent sections of the large floor space be- 
longing to the basement of the building. 

The hospital is very ably manned by Ham- 
ilton P. Duffield, chief surgeon; William Neu- 
zel, assistant surgeon; Miss Carolyn Paulson, 
superintendent of nurses; Miss Esther Cody, 
head nurse; Mrs. M. A. ShafTner, dietary 
superintendent, and Carl ShaflFner, steward. 

Besides the hospital addition, a new $4,000 
wing, lately added to the "Nurses Cottage," is 
now finished and occupied by the nurses of 
the hospital training school. This, with the 
old part, contains twenty-four rooms, three 
parlors, suits of three rooms for the assistant 
superintendent, two sets of baths and toilet 
rooms and is very nicely finished and prettily 
furnished. 

+■ 
New Hospital for Nervous Diseases. 

The new hospital for nervous diseases on 
Blackwell's Island is the first institution for 
the study of neurological maladies exclusively 
that has been opened in this country. The 
hospital was established by a number of well 
known medical men working in conjunction 
with Robert W. Hebbard, Commissioner of 
Public Charities, and is modelled on the lines 
of the Salpetiere Hospital, in Paris. 

In general it is planned to have transferred 
to the new institution all cases of brain dis- 
ease, such as apoplexy, tumors and acute and 



ADVERTISEMENTS 



©: momi&Bm ©: b. :© ;©i©i©i©: :©i©i©i©:©:€3? 



BLOOD GENESIS 

THE formation of a rich nutrient circulating fluid. Blood which shall contain an abundance 
of red corpuscles of the necessary structural and physico-chemical integrity. 
How to "build" such blood is an ever-present therapeutic problem for the physician to solve. 

is a powerful blood-forming agent ; it induces the generation of haemoglobin, the oxygen canying 

constituent of the blood ; it is a genuine haemoglobinogenetic. It feeds the red corpuscles 

with organic Iron and Manganese which are quickly and completely absorbed in cases of 

Anaemia from any cause, Ghlorosis, Amenorrhoea, Chorea, Bright's Disease, etc. 

I To assure proper filling of prescriptions, order Pepto-Mangan "Gude" in original bottles ( § xi). 

IT'S NEVER SOLD IN BULK. 

M. J. BREITENBACH COMPANY, 






LABORATORY. 

LEIPZIG. GERMANV. 



NEW YORK I 



Lactated Infant Food 



is the only food in the world which provides precisely the correct 
amount of proper ingredients as indicated by healthy mother's 
milk. The quantity taken by the baby is exactly that which it 
would require of human milk. The constituents are so skilfully 
compounded and in such perfect proportion that the most delicate 
baby can assimilate it readily. Lactated Infant Food babies are 
always healthy, happy infants. Thousands of physicians' little 
ones are Lactated Food babies. 



Physicians who wish to give Lactated In- 
fant Food a careful trial may have samples 
sent direct to patients by forwarding to iis 
names and addresses 



WELLS & RICHARDSON CO. 
BURLINGTON, VT. 



When you write Advertisers, pleuso mention TiiK Trained Nuusb. 



130 



THE TRAINED NURSE AND HOSPITAL REVIEW 



chronic injuries of the brain; spinal diseases, 
such as chronic diseases of the spinal cord, 
spinal tumors and spinal paralysis, and all 
cases of peripheral neuritis, including alco- 
holic neuritis and peripheral nerve injuries. 
The specific diseases included in the foregoing 
category comprise locomotor ataxia, ataxic 
paraplegia, spastic paraplegia, tumors of the 
spinal c«rd, multiple sclerosis, meningitis, 
cranial nerve paralysis, injuries to the brain, 
abscess of the brain, tumor of the brain, 
hemiplegia, cerebral paralysis of children, 
poliomyelitis, progressive muscular atrophies, 
neurit's, alcoholic multiple neuritis, epilepsy, 
hydrocephalus, myxedema, exophthalmic 
goitre, scleroderma, chorea (St. Vitus' dance) 
paralysis agitans, hysteria and neuralgia. 

Dr. L. Pierce Clark is president and Dr. E. 
L. Hunt secretary of the Medical Board of 
the new hospital, which includes Drs. Francis 
A. Scratchley, Pcarce Bailey, Smith Ely Jel- 
liflfe, Joseph Fraenkel, William B. Pritchard, 
J. Ramsay Hunt, Graeme Hammond and 
William Leszynsky. A consulting board, con- 
sisting of Drs. C. L. Dana, E. D. Fisher, 
George W. Jacoby, B. Sachs, Joseph Collins, 
Frederick Peterson and M. Allen Starr, has 
been appointed. There are now accommoda- 
tions for two hundred and fifty cases in the 
hospital. 

+ 

Addition to Faxton Hospital. 

The Vcdder Memorial Building, the new 
addition to Faxton Hospital, Utica, N. Y., has 
been completed. On the first floor is a patho- 
logical department, which was furnished by 
the president, Mrs. Edwin Thorn. Quite a 
number of the rooms were furnished by peo- 
ple interested in the hospital as a memorial to 
friends. One of these is a memorial to Mrs. 
Harriet B. Storrs, who for nineteen years 
was president of the board. Another is a 
memorial to Mrs. John A. Roberts. One of 
the end rooms was furnished by Mrs. H. A. 
Fitch, and is a memorial to John Sim Blaikie 
and William Blaikie, Jr. Another end room 
on the same floor is called "The Outlook," 
and was furnished by Mrs. John G. Brown, 
who was also for many years connected with 
the hospital when it contained the home de- 
partment. The high point of land on which 
the hospital is located gives it a fine view of 
the country for miles around, and from no 
point is it better than from these two rooms. 



One room is called the Sherman room and 
was furnished by San ford F. Sherman. The 
end rooms on another floor are memorials 
respectively to Delos M. Johnson and to Mrs. 
Georgiana P. Adams. The latter was fur- 
nished by Mrs. Edwin Thorn as a memorial 
to her sister. The children's room was fur- 
nished by Mrs. Richard W. Bacot, and is a 
memorial to Helen Wainwright. It is the 
children's room and the furnishing is most 
dainty and appropriate. Another room is fur- 
nished by Miss Powell. In the nurses' quar- 
ters on the fourth floor there is a writing 
desk and writing materials, the gift of Mrs. 
Robert S. Williams to the Alumnae Association. 
+ 
Toledo State Hospital. 

The twenty- fourth annual report of the To- 
ledo State Hospital filed with Governor Har- 
ris shows that large appropriations will be 
needed for that institution at the hands of the 
Legislature this winter. The principal items 
asked for are the following : For reconstruc- 
tion of hospital No. 8, $10,000; industrial 
building, $12,000; general repairing, $15,000; 
heating plant, $12,000; coal handling appa- 
ratus, $6,500; farm and dairy equipment, $34, 
000; ordinary repairs, $24,000; carpet and fur- 
niture, $2,500; greenhouse, $3,000; additional 
for attendants' salaries, $5,000, and for offi- 
cials' salaries an increase of $12,000. 

The per capita cost is shown to be $147.84, 
but this docs not include as it should the or- 
dinary repairs cost for the year. The popu- 
lation increased fifty over the preceding year 
and was 1,853. The trustees point to the fact 
that the farm and gardens of the institution 
produced $18,635.47. The whole number of 
different persons under treatment in the hos- 
pital during the year was 2,252, and the per- 
centage of recoveries based on admission.? 
was 22.31. 

+ 
Nurses Wanted. 

The Charlotte ( N. C.) Sanitoriuin, which is 
to open in April, will want thirty-five nurses 
and a superintendent of nurses. The superin- 
tendent will be decided on about March i. 
Undergraduate nurses, who have had training 
in other hospitals, and can show certificates 
for same will be given credit according to 
their certificates. All applications for nurses 
should be addressed to Dr. E. C. Register, 
Charlotte, N. C. 



ADVERTISEMENTS 



Antithermoline 

A Superior Surgical Dressing 
Made from the best quality of imported Welsh Kaolin 



[Reduced Size] 




A most effective application in all conditions of irritation, 
congestion, and inflammation. Now sold in screw top glass jars 
which can be resealed. 



FREE to Ntirses— NURSES* HANDY BOOK, containing 
much valuable data and useful information connected with a nurse's duties. 



G. W. CARNRICR CO. 

42 Stillivan Street New YorK City 

Wlien you write Advertisers, please mention Tuic Tuained Nuksb. 



3n tf)e iSursing; WoxVt^-contmuej 



Cambridge School of Nursing Closes. 

At the meeting of the trustees of the Cam- 
bridge School of Nursing, at looo Massachu- 
setts avenue, Cambridge, it was decided tliat 
the school be closed. The following report 
was presented by the executive committee : 

"It is with extreme regret that the executive 
committee states to the trustees that at its 
last meeting, October i, it was voted 'that as 
there has been no satisfactory response to 
the opportunities offered by the Cambridge 
School of Nursing, it is deemed advisable to 
close the school.* " 

Some of the considerations which have led 
to the decision are as follows: In January, 
1905, when the plans for the school were being 
made by a group of enthusiastic supporters 
of the method of training nurses carried out 
by Dr. Worcester in his school at Waltham, 
the demand for training was so great that the 
Waltham school was refusing applicants for 
admission, while the training school connected 
with the Massachusetts General Hospital was 
charging each nurse who entered the school 
$50. This demand for thorough, systematic 
training by young women seemed so encourag- 
ing that the founders of the school were led 
to expect an immediate response to the op- 
portunities offered. 

Advertising was begun. The house, 1000 
Massachusetts avenue, affording every possible 
convenience for the work, was ready for use 
at the opening of the school, October, 1905. 
The charge for tuition was $150 for the first 
year, and $75 for each of the three succeeding 
years, charges which in no way paid the ex- 
pense of the instruction of the student nurses. 
The first year began with eight students. Seven 
of these eight went to the hospital for their 
second year of training. 

Three now remain in the school. In Octo- 
ber, 1906, the school opened with six pupils. 
Four of those six have now begun their second 
year at the hospital. This year the school had 
but seven applicants, one of whom asked to 
begin the work with the understanding that 
she take only the training of the first six 
months. Of these twenty-one students, only 
thirteen agreed to pay the fees at the required 



intervals. To the others concessions were 
made, allowing pupils to delay payment or ren- 
der special service instead of paying money. 

At the July meeting of 1907, according to 
the advice of the executive committee, the 
length of the course was reduced to three years 
and six months, and the price of tuition to 
$250, as all felt that the charges, though in no 
ing all efforts in the support of one school at 
Waltham than by trying to support 
rwo schools, one at Waltham and one 
at Cambridge; yet the members of 
the committee, especially the physicians, 
feel that Cambridge is suffering a great loss. 
The continuance of the school, with a satis- 
factory number of student nurses, would fur- 
nish to the Cambridge Hospital, to the District 
Nursing Association, and finally to the com- 
munity at large a deeply needed, properly 
trained force of nurses. 

The trustees wish it to be distinctly under- 
stood that the closing of the Cambridge School 
of Nursing in no way affects the organization 
of the Cambridge Visiting Nursing Associa- 
tion, which is wholly distinct. In accordance 
with recommendation of the executive commit- 
tee, it was voted to take steps to close the 
school immediately. 

— The News Letter, IValtham, Mass. 

Arlington Grave for Nurse- 
Mrs. Sarah S. Sampson, who was buried 
December 24 in that section of Arlington re- 
^served for army nurses, was one of the best 
loved of the many women who did noble 
work in ministering to sick and wounded 
soldiers during the civil war. Mrs. Samp- 
son died at her home, 1622 Fifteenth street. 
She was the widow of Col. Charles Samp- 
son, of Bath, Me., and had been employed 
for many years in the Pension Bureau. She 
is survived by two daughters, Mrs. W. M. 
Hatch and Miss Beatrice Sampson, and a sis- 
ter. Miss Mary C. Smith. 

Mrs. Sampson was the founder of the 
Home for Soldiers* and Sailors' Orphans at 
Bath, and gave her constant thought and 
care for the surviving soldiers of the civil 
war and their widows and orphans. 



ADVERTISEMENTS 




Provide nourishment suited to the needs and digestive powers of the child from birth 
onward, according to the development of the digestive organs. 

THe ••Allenburys" MilK Food "No. 1" 

Designed for use from birth to three months of age, is identical in chemical composition with 
maternal milk, and is as easy of assimilation. It can therefore be given alternately with the 
breast, if required, without fear of upsetting the infant. 

THe ••Allenburys" MilK Food "No. 2" 

Designed for use from three to six months of age, is similar to " No. 1," but contains in 
addition a small proportion of maltose, dextrine and the soluble phosphates and albuminoids. 

THe •• Allen btirys" Malted Food "No. 3" 

Designed for use after the fifth or sixth month, is a partially predigested farinaceous food need- 
ing the addition of cows' milk to prepare it for use. 

Physicians familiar with the "Allenburys" Series of Infant Foods pronounce this to be the 
most rational system of artificial feeding yet devised. Their use saves the troublesome and fre- 
quently inaccurate modification of milk and is less expensive. Experience proves that children 
thrive on these Foods better than on any other artificial nourishment 

SAMPLE AND CLINICAL REPORTS SENT ON APPLICATION 



iJ?J[J 



THE ALLEN (Si HANBURYS CO., Limited 

TORONTO. CAN. LONDON. ENG. NIAGARA FALLS, 



'I "I"I"I " I"I"I"I " I"I " I"I"I"I"I"I " I"I **t'* I ** I '* I *' I ** I **I"I*'I**I "I " I '*I*4*^^**i**l*' ^' l"l «' l"| '» j"j"l"|"|"t"t"I"I"I"I"t"I"I " I"I"I"I"I *^ 

A Drink in Fevers 

A teaspoon of Horsford's Acid Phosphate added 
to a glass of cold water makes a cooling and refresh- 
ing acidulous drink for the patient during conva- 
lescence from typhoid and other febrile conditions. 

Its superiority over Dilute Phosphoric Acid, or 
any other acid, is due to the fact that it contains the 
phosphates of calcium, sodium, magnesium and 
iron, which means increased nutrition. 

Horsford's Acid Phosphate 

•is more palatable and strengthening than lemonade, 
lime juice or any other acidulous drink. 

1 RUMFORD CHEMICAL WORKS, Providence, R. I. 

^•^•^••^H•^4••I•4•^•^•I••^•I^4•+^H-•^+•^^••f•4^4•4~^+4^•^*4•4•^••^^•4••^•^•4••I«^•^4••H•4•^•4•^•M•^••^•^•I•H•+4• 

When you write Advertisers, please mention The Trained Nuksb. 



ifiteto 3^emeliie0 am. ^pliancesi 



The Demand Grows. 

No. 84 State street, Chicago. 
The Triton Company, Saratoga, N. Y. ; 

Gentlemen — Dr. R. H. Babcock desires us 
to carry in stock the Triton Bath Salts for 
the convenience of his local patients. * * * 
Ship us twelve dozen by express quick. Yours 
truly, Economical Drug Company. 

+ 
Burns of Infants. 

I have had excellent results from Unguen- 
tine, especially on a baby whose ear was 
burned at the back part of the lobe. I had 
tried almost everything, but to no purpose, 
yet Unguentine seemed to help it at once, 
soothing the pain so that the child slept al- 
most immediately, something that it had not 
done for several days. T. E. Kirby, M. D. 

Upton, Mass. 

+ 
Evans's Antiseptic Pastilles. 
Ethel Van Buren, of Van Buren and Sey- 
mour, writes : 

Montreal, March 25, 190 1. 
I take great pleasure in praising your Anti- 
septic Throat Pastilcs to all singers who suffer 
from irritation of the throat. They have 
proved a veritable boon to me ; in fact, I have 
termed them my "life savers," and I therefore 
feel it my duty to recommend them to my 
friends in the profession. 

Passiflora. 

Every physician requires almost daily a reli- 
able calmative to replace the many injurious 
narcotics and antispasmodics now in general 
use — something that possesses a pronounced 
specific action as a nerve sedative and hyp- 
notic and that will induce tranquillity and 
equilibrium of the nervous system. They have 
found in Daniel's Conct. Tinct. Passiflora In- 
carnata the properties that contribute to this 
result and removes conditions resulting from 
impaired nerve function. The opiates, bro- 
mides and several so-called calmatives insure 
sleep, but leave the patient with nerves 
strained and exhausted, while Passiflora gives 
rest without reaction. 



Use "Cresco" Food Products. 

We appeal with the utmost confidence to the 
medical and dental professions, a very large 
number of whom are our staunch and pro- 
nounced friends through the remarkably fa- 
vorable results that have followed the use of 
our products in their practice. 

It is now conceded by the best authorities 
in America and Europe that a rather liberal 
diet, with a certain amount of carbo-hydrates 
(starch and sugar) judiciously prepared, is 
essential to the successful treatmenf of dys- 
pepsia and diabetes. — Farwell & Rhines, 
Watertown, N. Y. 

+ 
Some More Opinions. 
Tofield, Aha, Canada, April 19, 1907. 
Ogden & Shimer, Middletown, N. Y. : 

Dear Sirs — I am simply delighted with the 
dear little jar of Mystic Cream. I had a very 
bad case of chapped hands in myself. Please 
find enclosed 25 cents for a large jar. 

Respectfully, Mrs. . 

The Hinsdale Sanitarium, Hinsdale, 111. 
Gentlemen — Received the sample of Mystic 
Cream and am so pleased with it that I send 
stamps for large jar. Send to same address. 

Mrs. . 

(Names furnished on application.) 

+ 
Proper Medication and Cheerful Company. 
During the past two months wc have met 
with more la grippe than anything else. Most 
cases will improve by being made to rest in 
bed and encouraging skin and kidney action, 
with possibly minute doses of blue pill or calo- 
mel. We have found much benefit from the 
use of antikamnia and salol tablets — two every 
three hours in the stage of pyrexia and mus- 
cular painfulness, and later on, when there was 
fever and bronchial cough and expectoration, 
from an antikamnia and codeine tablet every 
three hours. Throughout the attack and after 
its intensity is over the patient will require 
nerve and vascular tonics and reconstructives 
for some time. Cheerful company, change 
of scene and pleasant occupation are actually 
necessary in curing the patient. 



ADVERTISEMENTS 



The Dangers of Cow's Milk 

THE recent epidemic of Scarlet Fever In Chicago has awakened the whole 
country to the grave danger lurking in the Milk Supply of our large 
cities. Wherever milk is used that has not been properly safeguarded 
from the cow to the consumer, the infant mortality will always be high. 

Coincident with the Chicago Epidemic there comes a Report of the British 
Royal Commission on Tuberculosis. After five years' investigation, the Commis- 
sion conflft-ms the theory of Von Behring, that the tuberculosis of cows is a con- 
stant menace to the human race, and that consumption developed In later life, 
has often been contracted in infancy, from tuberculous milk. 

Nestle's Food 

does not require the addition of milk in preparing it for use, as it is a complete 
diet in Itself. The basis of Nestle's Food is cow's milk; so treated and modified 
that it will be easily digested, and will resemble mother's milk in its composition, 
as closely as possible. The milk supplied to the Nestle Factories is collected 
under the most rigid precautions, from cows that are under the constant super- 
vision of the Company's Veterinarians. Furthermore, the process of manufacture 
completely sterilizes the milk. This is fully set forth in our pamphlet, "Recent 
Work In Infant Feeding." A copy of this, with samples of Nestles Food, we will 
be glad to send to any physician. 

HCNRI NESTLE, 7 2 Warren St., New YorR. 



INSTRUCTION IN MASSAGE 

THE SYSTEM YOU WILL EVENTUALLY LEARN 

Swedish Movements, Medical and Ortliqpaedic Gymnastics 

Term: 5 Months Tuition Fee, $60.00 

Course in Electro-Therapy 
Term: 2 Months Tuition Foe. $25.00 

Course in Hydro-Therapy in all its Forms 

Term: 6 Weeks . .... Tuition Fee. $30.00 

WINTER CLASSES FORMING NOW 

7844 TREATMENTS GIVEN IN 1907 

No Bottor Gllnleal Exporlonce Posslblo 

All courses may be commenced at the same time and finished within three months. 

The instruction consists of daily clinical work and practical lessons on patients referred to our clinics from 
the various Hospital Dispensaries. Original Swedish (Ling) system, and Weir Mitchell's Rest-Cure system. 
All pupils attend clinics at several city hospitals. Payments can be made to suit your convenience. Particulars 
and illuftrated booklet on Massage upon request. An early appfication for admission is advisable. 

INSTRUCTORS 



T. D. Tagcart. M.D. (Jefferson Med. College). 

Wm. Erwin. M.D. (Hahnemann and Rush Med. Col.) 

Fkank B. Baird, M.D. (Univ. Pennsylvania). 

Max J.Walter (Royal Univ., Breslau. Germany, and 
lecturer to St. Joseph's, St. Mary's, Mount Sinai 
and W. Phila.Hosp. tor Women, Cooper Hosp.,etc). 



Helene Bonsdorff (Gymnastic Institute, Stock- 
holm, Sweden). 

LiLLiE H. Marshall HPennsylvania Orthopxdic 

Edith W. Knight > Institute). 

Helen T. Walker (St. Francis Xavier's Infirm- 
ary, Charleston, S. C, Penna. Orthop. Inst.). 

Wm. H. Montgomery (Penna. Orthop. Inst.) 



Pennsylvania Orthopaedic Institute and School of 

Mechano-Therapy (incorporated) 

1711 Green Street, PHILADELPHIA, PA. MAX J. WALTER, Superintendent 



136 



THE TRAINED NURSE AND HOSPITAL REVIEW 



I 



Composition. 

In Horlick's Malted Milk the food value 
of pure cow's milk is made available with the 
nourishment of choice malted grain in a per- 
manent powder form. The final process of 
manufacture is carried out in vacuo at a low 
temperature, eliminating the moisture, and 
during which the casein of the milk is modi- 
fied, so that it becomes soluble and very easily 
digested. This unique combination of the 
solids of milk with the phosphates, the carbo- 
hydrates and other nutritive principles of the 
cereals make a complete food of very wide 
application, possessing many advantages in 
cases where milk is indicated as the chief diet. 
+ 
In "Merrie" England. 

Hitchin. 
Messrs. Banger's Food, Ltd. : 

Gentlemen — I see in the Daily Mail and The 
Mirror to-day the correspondence about bot- 
tle-fed babies, and it does not speak well of 
them. 

God sends the food, the devil sends the 
cooks. My wife always sees to our baby's 
food. Here is a sample, about ten months 
old, brought up from birth on your food. 

As strong as iron, as lively as a lark, and 
as intelligent as possible, always happy, never 
cries. Thought you might like to know. 

Yours truly, F. Newton. 

+ 

Facts vs. Fancies. 

You can prescribe bichloride, carbolic, per- 
manganate, hydrastis, tannin, zinc or lead for 
leucorrhea or gonorrhea, if you want to, 
but you can't get any more positive results, 
effects, quicker but harmless, no matter what 
you use, than Tyree's Antiseptic Powder will 
give you. It conies as near absolute perfec- 
tion as material and skill can make it. Noth- 
ing can be put into a preparat'on for inflam- 
mation of the vagina and cervix to make it 
more desirable and satisfactory than is found 
in this one. You get the best antiseptic as- 
tringent and detergent known, all in one so 
modified by proportion and treatment that 
their individual objections have been elimin- 
ated. The bland, gentle and quick effect of 
this powder is due in part to the selection of 
chemical agents as near non-corrosive in their 
natures as possible. A trial package will be 
mailed free of charge to physicians and nurses, 
J. S. Tyree, Chemist, Washington, D. C. 



Anaemia. 

The consensus of modern scientific opinion 
is that anaemia is but a phase of malnutrition. 
Blood poverty is merely incidental — iron can 
never fulfil all the requirements for treat- 
ment. Moreover, there is more than sufficient 
iron in an ordinary daily diet to overcome the 
worst form of anaemia known — if it could be 
assimilated. Promote assimilation of food, 
and not only the blood poverty, but malnutri- 
tion in general will be overcome. This is the 
rational and scientific reason for the univer- 
sally acknowledged value of Gray's Glycerine 
Tonic Comp. in all forms of anaemia. Com- 
parative clinical tests have proven — time and 
time again — that Gray's Glycerine Tonic Comp. 
will cure many of the most rebellious cases. 

+ 
Chronic Rhinitis. 

Chronic rhinitis is an inflammation of the 
nasal mucosa, resulting usually from oft-re- 
peated occurrences of the acute disease. The 
mucous membrane is thickened, and intersti- 
tial infiltration with more or less complete 
nasal stenosis results. The treatment is gen- 
eral and local. Regulation of the primae viae 
and the upbuilding of the general system arc 
especially indicated. Locally the nasal pas- 
sages require the cleansing and purgative ef- 
fect of alkaline douches. For these purposes 
Glyco-Thymoline stands first in the list of 
remedies. It should be used as a douche in 
the proportion of one part to three of water, 
three or four times a day. — American Journal 
of Dermatology. — Ed. 

+ 
Importance of Manganese. 

A point which is frequently lost sight of in 
considering the treatment of anemia is the 
importance of manganese as a constituent of 
normal blood, and as an element ranking only 
next to iron in its power of building blood 
corpuscles and increasing the life-bearing 
hemoglobin of these cells. 

But perhaps the most important fact in 
connection with manganese is that once hav- 
ing entered the red cell it attracts iron to the 
coloring matter of the blood. 

The preparation known as Pepto-Mangan 
(Gude) is made on scientific principles. It 
contains a combination of iron and mangan- 
ese calculated to secure the highest possible 
blood-building efficiency without in the least 
interfering with the digestive functions. 






ADVERTISEMENTS 



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The package of the genuine bears this signature 



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Coityrlglht, 1907, Toastetl Corn Flake Co, 



138 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Clinical Investigation. 

In an interesting paper read before the 
Kansas State Physio-Medical Society at tlie 
annual meeting of the Physicians and Sur- 
geons' Society of the State of Kansas, Dr. 
J. E. Du Vail, of Kansas City, Kan., among 
other facts, stated : "It is not uncommon for 
one to learn of another valuable therapeutic 
agent, through J;he reports as published in 
our medical journals, showing the results in 
certain clinical investigations with some par- 
ticular remedy unknown to us. In this way 
was my attention directed toward Ergoapiol 
(Smith), and following the lines advocated 
(reporting any new and successful treatment 
to fellow practitioners), I wish to report my 
experience with this remedy, calling special 
attention to the results recorded in a few of 
the many cases in which I have used it with 
very gratifying results." 

+ 
To Keep Hair from Falling Out 

A visit to a well-known physician and an- 
other to a famous hairdresser, each of whom 
was asked this question, "What shall be used 
for washing the hair when there is an inclina- 
tion on its part to fall out?" resulted in the 
same answer from each: "Use Packer's Tar 
Soap for washing the hair." It was said to 
strengthen the hair, to keep it from falling 
out and to be cleansing. — Isabel A. Mallon, 
Ladies' Home Journal. 

We prefer Packer's Tar Soap to all other 
kinds for shampooing and the care of the hair, 
for the reason that its composition of sweet 
oils, pine tar and gljxerine exerts a favorable 
influence on the nutritive processes of the 
scalp, and in unhealthy conditions stimulates 
the follicles to return to normal activity. — 
American Journal of Dermatology. 

+ 
Did Not Believe at First. 

Troy, X. Y., Xov. 5, 1906. 
The Anasarcin Chemical Company, Winches- 
ter, Tenn. : 

I received sample box of your Anasarcin 
Tablets and used them in my own family in 
a case of valvular disease and renal stenosis. 
Such a pronounced localized edema of face on 
rising, and fingers ; seldom in extremities or 
abdomen. Had used the usual remedies with 
no noticeable effect. Began with Anasarcin 
Tablets one hour before meals and on retir- 
ing. The result was most satisfactory, for on 



second day face and iiands were normal and a 
better general condition of health has fol- 
lowed the continued use. 

I at first thought your literature rather 
strong, but now believe you are justified in 
11 you claim. Very truly, 

E. J. FiSK, M. D. 

+ 
A Graceful Testimonial Unsolicited. 

I feel that it would be an injustice were I 
not to write and tell you of the wonderful 
benefits I have derived from the use of Resinol 
Soap and Salve. I had been troubled for five 
or six years with a very disagreeable scalp 
disease, which caused me to try numerous 
daiwiruff cures, and all availed me notliing, so 
I finally tried Resinol Soap and Salve by 
shampooing my scalp, then rubbing tlie salve 
well into the scalp once a week. I did not 
use it longer than six or eight weeks, and 
now, for over five months, my scalp has been 
as clean as it ever was. I continue to use the 
soap as a shampoo every two weeks. This 
testimonial is unsolicited, and I give it simply 
because I feel it my duty. 

Charles F. Dwight, D. D. S. 

Marcus, Iowa. 

+ 
Post-Qraduate Courses in Massage. 

The Winter courses at the Pennsylvania 
Orthopaedic Institute and School of Mechano- 
Therapy, Philadelphia, in the Swedish system 
of massage, gymnastics, electro and hydro 
therapy opened on January 21, 1908. 

Large clinical material, a great variety of 
different diseases, a most modern and com- 
plete equipment, with extra practice at several 
of the largest hospital dispensaries are ad- 
vantages you find at the above institution. 
Thorough course in anatomy and physiology. 
Theoretical lectures by the staff physicians 
and upon invitation. Six thousand nine hun- 
dred and seventy-four mechanical treatments 
were given in the first eleven months of 1907, 
which guarantees the student ample clinical 
experience. 

In the last few years we have placed over 
two hundred of our graduates into well-pay- 
ing positions in hospitals and sanitariums, 
either to t.ike charge of the mechanical de- 
partments or as instructors to the nurses in 
training. 

Max J. Walter, 
171 1 Green street, Philadelphia, Pa, 



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A powerful tonic, a reliable reconstructive 
and a dependable respiratory stimulant. 

THE PURDUE FREDERICK CO. 
298 BROADWAY. NEW YORK 



140 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Horsford's Acid Phosphate. 

It acts beneficially in obstinate indigestion. 
— Dr. F. G. McGavock, McGavock, Ark. 

Perfect success in habitual sick headache. — 
Dr. W. W. Gray, Cave Spring, Ga. 

In dyspepsia, accompanied with prostration 
from mental overwork, I think it is a fine 
tonic. — Dr. John Gerdine, Athens, Ga. 

Promotes digestion and overcomes acid 
stomach. — Dr. W. W. Scofield, Dalton, Mass. 

+ 
Teaching Baby to Walk- 

Dr. Maude Kent, editor of the Medical De- 
partment of the American Housekeeper, in 
.speaking of children who do not walk readily 
owing to the condition of bone known as 
rickets, says : 

"Twice a day give a half teaspoonful of 
Scott's Emulsion. 1 he combination of the oil 
and hypophosphates of lime and soda will 
assist the other food to build bone tissue rap- 
idly, and is equally necessary where the spinal 
nerves are diseased." 

+ 
Treatment of Hemorrhoids. 

In a paper on "The Medicinal Treatment 
of Hemorrhoids Without Surgical Interven- 
tion" (Therapeutic Medicine, January, 1907). 
Dr. M. R. Dinkelspiel says that constipation 
is a most potent cause, and it must be cured, 
the defecations being so arranged that they 
occur at night, as the subsequent rest relieves 
engorgement. 

Locally, cleanliness is of primary impor- 
tance. The parts should be washed with 
witch hazel solution, of which one or two 
ounces may also be injected into the rectum. 
Of late he uses bismuth iodoresorcin-sulphon- 
ate suppositories (anusol), which relieve the 
congestion and inflammation and liquefy the ■ 
feces. 

+ 
Used All Over the World. 

This refers to the "Perfection" Bed Pan. 
We are told that most of the leading hospitals 
in the United States have adopted this pan, 
and last year several thousands of them were 
sold in Great Britain, where they are being 
made under Meinecke & Co.'s patents by Grim- 
wadcs, Ltd., of Stoke-on-Trent. 

There is no more need for hospitals to have 
in use bed pans which are uncomfortable and 
unsanitary. The "Perfection" Bed Pan is an- 



atomically correct in shape and causes no un- 
comfortable pressure against the spine. 

The "Perfection" Pan is endorsed by hun- 
dreds of physicians and nurses, and has also 
been adopted by the United States Army and 
Navy Hospitals. From every point of view, 
this is the pan that you should adopt in your 
hospital or recommend to your patients. Your 
own convenience and your patients' comfort 
both demand it. 

•I- 
A Paradox, but True! 

When a certain facetious individual made 
the statement that, having had the grip, he 
was sick for three weeks after he got well, 
he perhaps had in mind the lingering recovery 
to which, after treatment of the acute or in- 
flammatory conditions, most persons are rele- 
gated under the impression that Nature will 
do the rest. It is comparatively easy to con- 
trol the cough, allay the irritation of nose and 
throat, and sterilize the secretions, destroying 
their purulent character. Creso-Terpin Comp. 
(Wampole) will do all this, but to get zvell 
the patient must recover vitality enough to 
throw off the morbid products with which the 
system is loaded. One of the best treatments 
for this after-condition of the grip is Wam- 
pol^'s Preparation of Cod Liver Extract, which 
is a long-tried and well recognized vitalizing 
reconstructive tonic upon which patient, nurse 
and physician can always rely. 
+ 
Lysol. 

Lysol, the best-known disinfectant, germi- 
cide and antiseptic for use in surgery, gyne- 
cology, obstetrics and general practice, is now 
used daily in nearly every hospital in tiic 
United States, including the Army, Navy and 
Public Health and Marine Hospital Service. 
It has been demonstrated to the satisfaction 
of the majority of doctors that Lysol is more 
efficient than either bichloride or carl>olic 
acid; first, because it is non-poisonous; sec- 
ond, because it does not affect the skin; third, 
it does not coagulate albumen and allow the 
germ to live inside its hardened capsule ; 
fourth, the bactericidal action of Lysol is five 
times stronger than that of carbolic acid. 

The list of hospitals, clinics and dispensaries 
using Lysol has so grown that it is practically 
a directory of the best institutions of the kind 
in the world. Lehn & Fink, New York, are 
sole agents for Lysol in the United States. 



i 



Cable of Contents 



Page 

Is THE Three Years' Course in Training Schools for Nurses Unneces- 
sarily Long ? Hugh Cabot ^ M.D. 143 

Comments on the Visiting Committee'.s Report Charlotte A. Aikens 150 

Parliamentary Law Cora Welles Trow 1 55 

Pensions for Army Nurses Anita Newcomb McGee 158 

Infant Feeding (Continued) Myer Solis-Cohen, A.B., M.D. 160 

Pneumonia (Continued) Atuiie E. Hutchinson 163 

Dispensary Work A. M. N. 167 

Practical Suggestions for Nurses Grace B. Homman 168 

Reminiscences of an Ex-Army Nurse Cecilia McHugh 170 

The Foundling Asylum in Florence .S. D. H. 174 

Department of Army Nursing Dita H. Kinney 176 

Editorially Speaking 178 

In the Nursing World 181 

The Editor's Letter-Box 189 

Book Reviews 194 

The Hospital Review 196 

New Remedies and Appliances 204 

The Publisher's Desk 212 




A Clean, White, Healthy Scalp 

is absolutely essential to the growth and 
beauty of the hair. 

Packer's Tar Soap 

used systematically as a shampoo is a reliable means 
of restoring and maintaining normal 
conditions of the scalp structures. 

Korth!rly-five years il has been endorsed and rec- WjL BH^^TkCKEft'^ 
ominended by the medical profession as the stand- H W^^" buunc 
ardsoap forthehygieniccare of thehairandslcin. M ^SmQ^I SO^-^ 

Our little booklet on " The Value of System- '' 

atic Shampooing, "with a sample cake of soap, will 
be sent to nurses who will mention this journal. 

THE PACKER MFG. CO.. New York 



Wheal you write Adrertlsere, please mention The Teainbd Nuesb. 




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Every part of the inside of the Pan is just as visible and open for inspection 
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will be recognized and appreciated by Hospital Superintendents and 
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It Is a comfortable Pan, being curved at the front to fit the body, and relieve 
all pressure from the spine. 

The recess at the front end gives increased capacity and prevents the Pan 
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and cleansing. 



All Hospitals using the "Perfection" Bed and Druche Pan, will find It of 
advantage to have some of our "Simplex" pans also, for use where douching Is 
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Clie Craineti Jturse ana 



VOL. XL. 



NEW YORK. MARCH, 1908. 



NO. 3 



''36 t|)e Cijree iears* Course in Craining ^cfjools 
for JBturses WinmttQemlv ilong?''* 



HUGH CABOT, M.D., BOSTON, MASS. 



AMONG those interested in the train- 
ing of nurses there is probably no 
subject which is discussed more fre- 
quently, with more interest and with less 
unanimity of opinion than the length of 
the curriculum. This is in part due to a 
natural difference of opinion, but in part 
also to a radically different view-point. 
In a word, it makes a difference who is 
discussing the question. 

At the outset of any discussion of the 
subject it seems wise to consider for a 
moment what classes of people are en- 
titled to opinions worthy of considera- 
tion, and what relative value these opin- 
ions should have. I have been struck by 
the fact that the majority of published 
opinions are those of superintendents of 
nurses, or at least those professionally 
interested in the teaching of nursing. 
Deeply as we must respect their opinions, 
it may fairly be doubted whether they 
are in as sound a position to judge of 
their finished product as those who have 
a less personal interest. Until very re- 
cent times it would have passed without 
discussion that the medical profession 
was in the soundest position to judge of 
the qualifications of the trained nurse, 



and even to-day I suspect that it is likely 
to prove the last tribunal. The general 
public is certainly interested but is 
swayed by so many reasons other than 
those of real technical efficiency in judg- 
ing of a nurse's qualifications that I am 
by no means prepared to accept its judg- 
ment as universally sound. The great 
body of undergraduate nurses is, I be- 
lieve, a thoroughly safe tribunal, but it 
has never as yet been possible to obtain 
its unbiased opinion. The alumnae soci- 
eties and State associations have in a 
great majority of cases voiced the senti- 
ment not of the large body of nurses, but 
of a small number of executive officers, a 
large proportion of whom are superinten- 
dents of nurses, superintendents of hos- 
pitals or at least not practicing nurses. I 
believe therefore that in the discussion of 
the results now obtained in training 
nurses the opinion of the medical man 
who actually sees the nurses at work is 
the soundest basis on which to form an 
opinion of the final result. 

One other point should be cleared up 
before entering upon a detailed discus- 
sion. What are we to understand as the 
ordinarily accepted meaning of the words 



•PrcHented at tlio meeting of the New England Association for the i^ducntlon of Nurses, and 
contributed to The Trained Nurse. 



144 



THE TRAINED NURSE AND HOSPITAL REVIEW 



"trained nurse"? For the purpose of 
this discussion I shall hold the term to 
mean a nurse qualified to take care of 
patients as seen by the practitioner in 
private practice. This restriction seems 
a fair one because it is the meaning or- 
dinarily understood and generally accept- 
ed by the mass of doctors, nurses and the 
general public. I do not believe that it 
is ordinarily intended to cover women 
trained for administrative positions, for 
inspectors of schools, of boards of 
health, or for women who devote their 
lives to being assistants to surgeons or 
specialists or office nurses. Clearly such 
women will need special training and 
special qualifications, and is seems wholly 
unreasonable that the standard of train- 
ing for nurses in general should be fixed 
with the view to preparing these special- 
ly qualified persons. 

In discussing the length of the curricu- 
lum the battle has generally been waged 
over the two years' course versus the 
three years' course. Why this particular 
combination of months has been selected 
I am unable to discover, and the ques- 
tions seem to me to be. not whether three 
years is better than two years, but 
whether the three years' course is unnec- 
essarily long or unduly severe for prepar- 
ing nurses for ordinary practice. I do 
not, therefore, propose to present a brief 
in favor of either course, but rather to 
discuss the soundness of the present three 
years' course requirement, and inquire 
whether it is in all respects satisfactory. 

Last March a thoroughly representa- 
tive association of superintendents from 
New England, known as the Linda Rich- 
ards Club, prepared a statement strong- 
ly favoring the three years' course. After 
some investigation, no more clear, terse 
and decided expression has come to my 
hand, and it seems to me fairly to repre- 
sent the accepted doctrine of the advo- 



cates of the three years' course. I pro- 
pose, therefore, to take up these resolu- 
tions one by one before venturing to ex- 
press any personal opinion. 

They say: 

I. "The public has been educated to 
expect more from the nurse than it did 
ten years ago. We should be able to 
supply women qualified to meet the re- 
quired standard, whether in the home, the 
school, the settlement or elsewhere. She 
is now recognized as an educational and 
economic factor in the community of 
great value; therefore, sufficient time 
should be allowed for proper prepara- 
tion.'' 

We have even higher authority for this 
same view in an address by the president 
of the American Society of Superin- 
tendents of Training Schools for Nurses. 
Miss Banfield says: "There are many 
other branches of social service also open 
to women, in which hospital training is 
almost invaluable — health board inspec- 
tion, factory and bakeshop inspection, 
charity organization work, nurses' settle- 
ments, are a few of the many avenues of 
work in which a nurse's training is ex 
ceedingly valuable, and in some cases an 
absolute requisite. This leaves out of 
account the many executive positions in 
hospitals and other institutions, which 
we all of us find it so hard to secure com- 
petent women to fill. And yet. in the 
face of all this, we have the superficial 
and thoughtless cry that nurses are being 
'taught too much,' and while some say 
there are too many of them, others say 
there are not enough. And to remedy 
all evils a return to two years' training, 
less well taught nurses and a lower stand- 
ard is thrust upon us as a panacea." 

Here at the outset we meet with the 
expressed opinion, that the Hospital is 
not intended to train nurses in the ordi- 
nary sense of the word. They state with 



THE TRAINED NURSE AND HOSPITAL REVIEW 



145 



every appearance of sincerity that the 
public expects more than it did ten years 
ago. I confess that this has by no means 
been my experience, and I am encour- 
aged to find it is not the opinion of oth- 
ers. An editorial in a contemporary 
journal expresses dissent as follows: 
"Are there not any number of graduates 
of ten years back who are just as much 
in demand and give just as much satis- 
faction to the public as the more recent 
grjiduates? Does the average patient 
care whether the nurse he has employed 
is competent to serve on boards of 
health, fill an executive position, write 
for a magazine, or talk child labor or 
woman's suffrage at a nurses' conven- 
tion? We believe not." 

It has certainly been my own experi- 
ence that the nurses trained ten years ago 
are fully up to modern requirements, and 
I have sometimes been tempted to think 
that they had more useful knowledge 
and less useless information than their 
more elaborately trained sisters. In any 
case, it seems to me that training schools 
for nurses should no longer be spoken of 
as such, if it is their avowed purpose to 
train women for very much broader 
fields. If they no longer devote their 
time to training of nurses this fact 
should be clearly stated in the prospectus, 
and those hospitals which do confine 
themselves to training women for the 
care of the sick should not be criticized 
because they do not go beyond their 
avowed purpose. 

2. "The medical profession in its won- 
derful strides forward has become ac- 
customed to receive skillful assistance 
and intelligent co-operation from the 
nurse. The three years' training makes 
it possible to give the highest grade of 
work and continued satisfaction." 

With the view that the medical pro- 
fession is dissatisfied with any other 



than the three years' training I cannot 
agree, and though I have made many in- 
quiries I have been unable to find that 
this opinion is generally held. I cannot, 
therefore, accept without further proof 
the view that the medical pro^fession 
favors the three years' course, and I 
doubt whether the superintendents of 
nurses are in a particularly sound posi- 
tion to judge the wants and desires of 
the medical profession in general. 

3. "The advantage of the three years' 
course of training to the pupil is beyond 
doubt. In two years it is impossible to 
give equal and uniform experience in all 
the departments of a general hospital. 
She must be hurried from place to place, 
gaining cursory and superficial knowl- 
edge of each, and in the nervous strain 
occasioned by the too frequent changes 
becomes unequal for the class work de- 
manded of her. It would be impossible 
in two years to give a pupil experience in 
administrative and executive work, now 
so satisfactorily introduced in the longer 
course. The special course provided by 
the system of affiliation between hos- 
pitals, for the express purpose of better 
preparation of nurses would no longer 
be possible. The hospitals frequently 
lose the services of its senior class for 
several months while they are sent at 
considerable expense to take these spe- 
cial courses." 

If we admit the premises of this 
statement we must admit the conclusion, 
but I confess to some doubt as to the 
necessity of giving all a "uniform experi- 
ence in all departments." It is by no 
means clear to me that she will require 
uniform experience, and it is abundantly 
clear that some branches in which she 
receives instruction might be omitted. 
For instance, I do not believe the medical 
profession seriously requires administra- 
tive or executive experience for the care 



146 



THE TRAINED NURSE AND HOSPITAL REVIEW 



of private cases, and I incline to the opin- 
ion that such training is little short of 
time wasted. I have been to some trouble 
to learn the opinion of graduates in the 
three years' course as at present given 
in our large hospitals. Many of them 
told me that their third year was largely 
repetition, contained much drudgery 
and left them tired out. I am, therefore, 
skeptical as to the soundness of the 
statement "that the advantage is beyond 
doubt." 

4. "To the nursing profession as a 
whole and individually a general return 
to the two years* course would seem a 
matter of injustice. The present de- 
mand upon the graduate nurse makes a 
broad general professional education im- 
perative. If she is imperfectly prepared 
she finds herself restricted in usefulness 
and unable to take advantage of the in- 
creasing opportunities for work." 

In a paper by Miss Alline a similar 
view is expressed as follows : "The gen- 
eral feeling of all superintendents, and 
in fact, all graduate nurses, is that the 
three years' course is necessary unless 
the student can come to the schools 
much better prepared than are the ma- 
jority of those in training. More years 
in school attendance and better home 
training — otherwise a preparatory course 
is the only substitute for the approved 
term. This leaves a two years' course 
quite out of the question." 

This is undeniable if the facts are cor- 
rect, but these statements are based upon 
the presumption that the opinion of the 
large body of graduates is correctly 
stated. I find in a contemporary nurs- 
ing journal the following somewhat pun- 
gent paragraph which bears upon the 
question : 

"Perhaps the most widely discussed 
instance of the attempt of the minority 



to overrule the majority is the question 
of the two or three years' course. On 
one hand we see nurses who are experi- 
enced in private duty in favor of the 
two years' general course which will 
serve as the foundation of their nursing 
education, after which they shall be at 
liberty to choose for themselves what 
special line of work they prefer. On 
the other hand, the institutional workers 
seem determined to force the three years' 
course on all nurses." 

I have seen no good reason for be- 
lieving that graduate nurses in general 
believe that a two years' course will not 
properly fit them for private nursing. It 
is probably true that it does not fit them 
for higher and more special occupations, 
but this matter of special training can- 
not, I think, be reasonably expected of 
training schools for nurses as such. If 
nurses desire special training for special 
work it should be obtained in a special 
course and by giving extra time. 

5. "Acknowledging that under certain 
conditions and in certain schools the 
three years' course would be unwise, we 
feel that in the great majority of schools 
the three years' course is both possible 
and practicable. We are also willing to 
acknowledge that the best interests of 
the pupil nurse have been sacrificed in 
many instances, and that much extrane- 
ous matter has been brought into the 
curriculum ; yet at the same time we be- 
lieve that superintendents of training 
schools throughout the country are keen- 
ly alive to the situation and are bravely 
working, frequently against great diffi- 
culties, to bring about a fair, honest sys- 
tem of training." 

The substance of this paragraph may 
be admitted without damage to our con- 
tention. It has no fact in particular 
bearing upon the length of course. 



THE TRAINED NURSE AND HOSPtl^AL REVIEW 



147 



6. "It does not seem reasonable to 
ascribe the decrease in applications en- 
tirely to the lengthened course. From 
experience and observation we should 
not recommend a return to the two years' 
course as a remedy, but suggest shorter 
hours, better instruction, comfortable 
homes, good food, just treatment and 
establishment or non-establishment of an 
allowance, as the conditions would seem 
to indicate." 

The paragraph reminds one of the set- 
ting up of a straw-man for the purpose 
of knocking him down. I do not think 
it has been claimed that the three years' 
course is the sole cause of the decrease in 
applicants. Certainly this has not been 
generally asserted. On the other hand, 
the resolution does not challenge the 
fact that this is a serious item in the 
account. All the other reasons which 
they suggest are, as far as we are aware, 
equally appropriate to the two years' 
course. 

7. "The hospital benefits from the 
three years' course, owing to the higher 
class of work obtained from the con- 
tinued presence of the staff of nurses. 
We believe that the advantages to the 
hospital are balanced by the advantages 
to the nurse, and the obligations of the 
hospital to the nurse are not greater 
than those of the nurse to the hospital." 

I do not feel by any means competent 
to discuss the advantages or disadvan- 
tages of the length of course to the hos- 
pitals. This is rather the province of 
the hospital superintendent, and will re- 
ceive careful consideration at his hands. 
Furthermore, I prefer to-night to dis- 
cuss only the advantages to the nurse; 
to include the hospitals in the discussion 
would lead us too far afield. If, how- 
ever, it should appear that the hospitals 
will suffer from a shorter course, it 



must first be shown that they are now 
getting better service than they did ten 
years ago; a proposition which I seri- 
ously doubt. 

Having thus roughly outlined my rea- 
sons for differing from this eminent 
body of superintendents,' it is but proper 
to state somewhat more in detail my ob- 
jections to their policy. 

The three years' course has been on 
trial long enough to give data on which 
to study it. One of the most serious ob- 
jections seems to me to be the length if 
time required. When the change was 
made it was hoped and expected that a 
reduction of hours would follow, but 
this reduction has not materialized, and 
at the present time practically a year has 
been added to the course and the pres- 
sure has not been reduced. I think it 
will be generally admitted by medical 
men of hospital experience that house 
officers do not stand more than two years 
of work without physical damage. Even 
the sixteen months appointment now 
given at the Massachusetts General Hos- . 
pital leaves the men not infrequently 
worn out. I do not think it is safe to 
require three years at the present pace 
in training schools for nurses. 

The champions of the three years' 
course ask for a reduction of the hours 
to eight. This is roughly speaking a re- 
duction of one-third in the hours. If one 
year were taken from the course and the 
hours remain as at present, the reduction 
would likewise be one-third. In other 
words, the reduction to eight hours with 
the three years' course will give the 
nurses substantially the same amount of 
working time that they had under the old 
two years' course. Many nurses with 
whom I have talked feel that the present 
daily requirement is not excessive if the 
strain does not last more than two years, 



148 



THE TRAINED NURSE AND HOSPITAL REVIEW 



and many of them would prefer the pres- 
ent twelve-hour day with the two years' 
course to the eight-hour day with a 
three years' course. They feel, and I 
think rightly, that the continuity of work 
free from interruptions is an advantage 
and the strain not too great. 

Has the added year added to their 
stock knowledge by a third ? I doubt it. 
The extra year has been filled with 
training in valuable but unessential 
branches, and with repetition which is 
unnecessary and amounts to drudgery. 
The special branches of operating-room 
work, assisting at operations, administra- 
tive experience and similar special 
courses are of value beyond doubt, but 
they are not necessary to the training 
of nurses for ordinary private practice. 
These courses might well be made elec- 
tive and not a part of the required 
( ourse. 

It was the hope of the advocates of 
the three years' course that it w')ald 
mean a reduction in the hours and an 
opportunity to teach in a more leisurely 
fashion and at lower pressure. This 
hope has not been realized, because it i> 
nearly an economic impossibility for hos- 
pitals as at present organized. It would 
be improper in these times of increased 
expenses without corresponding increase 
of income, for trustees to add to their 
financial burdens. The decrease of hours 
by one-third means a large increase in 
the number of nurses at a cost to the hos- 
pital on an average of five hundred dol- 
lars each. The reduction in salary 
paid to the nurse whiph came with the 
change to the three years' course was 
so small as to give an insignificant 
amount of money to be used for the pur- 
pose of increasing the force of nurses. 

The increase in the length of course 
and the decrease in salary, though small, 



have been important factors in decreas- 
ing the number of applications. The 
dilemma is, therefore, this: The super- 
intendents of nurses, by constant and per- 
sistent pressure, succeeded in increasing 
the course to three years and trusted to 
chance to decrease the number of hours. 
This decrease has failed to materialize, 
because practically impossible. The re- 
sult is a three years' course with as much 
pressure as the old two years' course, 
with resulting damage to nurses and 
without corresponding benefit. The cure 
of the condition lies either in a reduction 
of the hours or a return to the shorter 
course. There is nothing in the condi- 
tion of hospital finance to suggest that 
a decrease of hours will be more possible 
than in the past. A reduction in the 
length of course, therefore, seems essen- 
tial, and two of the large New York hos- 
pitals have already made it. 

The present dearth of nurses which 
hospitals are experiencing can be consid- 
erably relieved in large institutions by 
giving elective courses to properly qual- 
ified graduates from other schools with- 
out pay. These courses will be much 
in demand by nurses from special hos- 
pitals or from hospitals in which the 
amount of material available for teaching 
is small. It should also be possible to 
oflfer elective courses during the third 
year to nurses graduated under the two 
years' course, and by allowing them spe- 
cial privileges compensate them for lack 
of salary. Nurses desiring special 
training should be offered special oppor- 
tunities, and for these they will, I think, 
be willing to pay in time if not in money. 
In this way the advantages and splendid 
opportunities of the great institutions 
may be offered to more nurses witlout 
anv increase in the whole number of 
those desiring a nurse's training, and in 



THE TRAINED NURSE AND HOSPITAL REVIEW 



149 



this way the present failure of the sup- 
ply to meet the demand will be reHeved. 

The present situation may be briefly 
summarized thus : 

The three years' course has add^I a 
year of great strain without correspond- 
ing advantage. The reduction to ei 'ht 
hours a day, which the superinte- <dents 
of nurses are so strongly urging, is prac- 



tically a return to the two years' course 
in another form, and will show no sub- 
stantial advantage over the old arrange- 
ment. The present dearth of applicints 
may be relieved by the adoption of a more 
generous policy on the part of large hos- 
pitals by which the wealth of material 
in their control is oflfered to graduates of 
small institutions. 



Discussion to Follow. 




GRADUATING CLASS, ST. MARY'S HOSPITAL, rniLADELPHIA. PA. 



Comments on ftit ¥^istttng Committee's 3l^eport 



CHABLOTTE A. AIKBNS. 



THE New York City Visiting Com- 
mittee of the State Charities Aid 
Association for the Department of 
Public Charities and for Bellevue and 
Allied Hospitals, has issued a letter to 
the Commissioner of Public Charities 
bearing on the best length of a general 
training for nurses. The whole report is 
interesting, even if there is little in it in 
the way of argument that has not found 
expression in nursing circles heretofore. 
Any discussion as to the required 
length of a course of training for nurses 
at this time loses somewhat in force 
without some definition or explanation 
as to what a course consists of. The 
term "course of training" has come to 
mean many different things to different 
people. No mention is made in the re- 
])ort as to what the curriculum of this 
course of training is to be in these muni- 
cipal hospitals. It is presumed, there- 
fore, that the curriculum under consid- 
eration is that reconVmended by the 
New York State Board of Education. 
We believe that to deal with any ap- 
proach to thoroughness with the course 
outlined in that syllabus, at least from 
three and a half to four years would be 
necessary, considering that a pupil nurse 
is expected to do at least some bedside 
work. There is quite sufficient theory 
and laboratory work outlined in the syl- 
labus to occupy the average nurse can- 
didate two entire school years without 
doing a day's nursing. It would be ex- 
ceedingly difficult for any one to con- 
vince an impartial observer who knew 
anything of the responsibilities and rush 
and strain of hospital life, that any 
school in three years was doing justice 



to that course; that its pupils were get- 
ting more than a smattering of a great 
deal of the matter prescribed, if the 
pupil nurses were doing even eight 
hours of practical work each day. It is 
a well known fact that most of them 
are doing a good deal more than eight 
hours nursing every day, however much 
one may regret it. 

• If, as an increasing number of hospital 
people believe, the time has come 
to quit trying to give our nurses a 
modified medical course; to cut out a 
wTiole lot of lecturing on embryology, 
physiologic psychology, pathology, his- 
tology and other purely medical sub- 
jects that nurses do not need in order 
to give intelligent bedside care to the 
sick; if a rational course in nursing can 
be studied out and agreed on, it can be 
given in two to two and a half years. 
The New York State curricuhun can 
not. So thus far we are in accord with 
the committee's recommendation to re- 
tain at least the three years' course if 
that syllabus is to be followed. To do 
justice to it four full years would be 
necessary. 

Regarding the weight wliicii should be 
given to the resolutions of the Nurses 
Associated Alumnae in favor of the three 
years' course it will be admitted that 
much depends on who is doing the 
weighing. There are wheels within 
wheels in nursing, as in other lines of 
work. Some of these wheels are 
not plainly visible and the committee is 
not to be blamed for not noticing them, 
but the .wheels are there, nevertheless. 

On the floor of the convention of 
the American Hospital Association in 



THE TRAINED NURSE AND HOSPITAL REVIEW 



151 



Chicago last September, at its closing 
session, Mr. John Fehrenbatch, Super- 
intendent of Cincinnati City Hospital, 
rose to speak in favor of retaining the 
three years' course. We quote his exact 
words from the official report and sug- 
gest that they be kept in mind when 
deciding on the weight that should be 
given the resolution referred to : '"'I am 
opposed to the reduction of the term in 
training in the interest of the tramed 
nurse. If we reduce it to two years it 
will increase the output one-third, that 
is 33 per cent. That 33 per cent, means 
a reduction in the price of the nurse. 
I am in favor of the nurse getting good 
pay when she goes out, but if she has 33 
per cent, more competition than she has 
now, how is that sort of legislation go- 
ing to benefit the nurse?" This is a 
plain statement of facts that should con- 
vince the committee that there are pos- 
sibly some other considerations besides 
educational ideals, and anxiety that the 
sick be cared for in the most efficient 
manner, which might have faintly in- 
fluenced the resolution referred to. 
There is nothing wrong or unusual at 
all in having such ideals or in wanting 
to keep up tiie prices and reduce com- 
petition. It is exactly what is done in 
any business. The thing we object to is 
that this economic aspect should be ap- 
parently overlooked, and the impression 
given that this hastily considere.l reso- 
lution proposed on the deck of a 
steamer while en route to the Jamestown 
Exposition should weigh' particularly in 
deciding such a question. 

Under the heading "The Situation in 
New York City" the committee's report 
states that "Information has been se- 
cured as to the number of applicants, 
the number accepted as probationers, 
and the number accepted as pupil 



nurses for eight of the largest training 
schools of the city. These figures show 
that the number of applicants to these 
eight city training schools decreased in 
1903 from the number in 1902; that the 
number then remained practically the 
same until a decrease occurred in 1906; 
that so far for 1907 there has been a 
decided increase pro rata over 1906 for 
the eig'ht training schools for which the 
figures had been obtained, excepting 
with St. Luke's and the Presbyterian, 
which had, however, more applicants 
than any of the other schools." One is 
led at once to wonder, after reading this, 
why there should have been such em- 
barrassment in New York hospitals as 
has existed this last year. These com- 
parisons seem to show that present con- 
ditions are encouraging, but again we 
are at a disadvantage in considering 
these statements, because either our 
hospital terminology or our hospital con- 
science is in a sad state of confusion as 
regards the meaning of the word "ap- 
plication" as applied to hospital training 
schools. To illustrate: The president 
of the board of a neW hospital stated to 
the superintendent, who had been en- 
gaged several months in advance of the 
opening to organize a training school : 
"We have already twenty-five applica- 
tions for our training school." The 
situation looked encouraging, but when 
the so-called "applications" came to be 
analyzed, it was found that they were 
letters from twenty-five young women 
asking for information about the school 
or saying they were considering enter- 
ing some hospital for training. Blanks 
were, of course, sent to all of them and 
out of the twenty-five, four i»janks 
were returned making formal and bona- 
fide application. 

The whole question of "application" 



152 



THE TRAINED NURSE AND HOSPITAL REVIEW 



and what we really mean by it needs a 
very thorough thrashing over before 
any statistics on the subject will be very 
illuminating. 

One of these training schools con- 
nected with the Department of Chari- 
ties in New York stated in its report for 
1905 — issued in 1906 — ^that "during the 
year there were 450 applicants, with 
very few exceptions all eligible. Forty- 
seven were admitted to the probationary 
course of training." The superintendent 
of this training school has not hesitated 
to admit a most serious embarrassing 
handicap for lack of nurses within the 
last year. Now will the committee or 
anybody please explain why in the name 
of common sense if that school had 450 
bona fide applicants listed for admis- 
sion to the training school and the great 
majority were eligible candidates, they 
did not admit more than forty-seven out 
of the whole number if they needed 
nurses? The four hundred and three 
who were not accepted had they been 
admitted in 1905 or 1906 would have 
made a corps of valuable nurses for 
HJ07. Surely half of these 403 who were 
"not admitted would have relieved tlxc 
embarrassment and strain in that insti- 
tution, and the other half might pos- 
sibly have been persuaded to enter 
some other school under the Depart- 
ment of Charities rather than be totally 
rejected. Four hundred and three ad- 
ditional pupil nurses would have surely 
relieved somewhat the strain ill the 
municipal hospitals in New York this 
past year. 

The only explanation we can give for 
this apparently incongruous state of af- 
fairs is that the 450 eligible applicants 
were really only inquirers — possible can- 
didates who were considering nursing 
as a vocation, and whose attention had 



been directed to the school referred to. 
Now this explanation may not be cor- 
rect, but it is the only rational explana- 
tion that we can give. Evidently the 
great majority of this little army of 450 
decided not to enter. Why? The school 
has a splendid nurses' home and one of 
the best superintendents in the whole 
country. We don't know what class of 
food the nilrses in that school get, nor 
how many hours' duty a day is required, 
but we do know the reputation of the 
school throughout the country is good. 
Why didn't these over four hundred eligi- 
ble candidates who had communicated 
with the school materialize? Family and 
personal reasons may have prevented 
some. Others probably entered other 
schools. Some doubtless did not mean 
business. But after looking at that ques- 
tion as it concerns that hospital and a 
vast number of others with similar expe- 
rience, the only conclusion we can come 
to is that the length of the term of train- 
ing, the weight of the burden of theory 
impose^l, the difficulty of the studies — the 
whole general conditions for entrance 
and graduation have been made so for- 
midable that a great many practical young 
women of the twentieth century who 
have a bent toward nursing turn away 
dismayed at the idea of having to master 
the ponderous studies and do practical 
nursing for three years before they can 
be considered qualified to care for the 
sick. 

The writer's own experience and the 
experience of others who have spent 
years in hospital work, who have 
changed from a two to a three years' 
course, is that the number of bona fide 
applicants as compared with the num- 
ber of possible candidates who write 
asking for blanks and information is 
much less under the three-year scheme 



THE TRAINED NURSE AND HOSPITAL REVIEW 



153 



than when the term was two years. We 
perhaps get as many or ahnost as many 
letters of inquiry as under the two-year 
rule, but we do not have anything Hke 
as many who are wilHng after they learn 
the conditions to enter for three years 
as when the course was two years. We 
get into communication with the individ- 
uals, we get requests for application 
blanks, but somehow we don't land the 
candidate as we once did. We don't 
have long waiting lists as we once did 
when the course was two years. The 
great mass of them are not heard from 
again. The nursing material is in the 
country, but we don't get it. We get 
but a small proportion of what we might 
get, if we studied the situation as a bus- 
iness man studes his field, and adjusted 
ourselves as the times demand. A great 
many of the ideals advanced are unques- 
tionably good, but we have not reached 
the Utopian stage of civilization when 
it is wise to attempt to carry all of them 
out. 

With the conclusion in the letter, 
"That the shortening of the course of 
training will increase to some degree 
the number of applicants of a less de- 
sirable class; that the number of ap- 
plicants of a more desirable class would 
only be increased slightly if at all, and 
this increase would be more than offset 
by the additional numbers required, be- 
cause of the fact that the entire force 
would be changed within every two 
years instead of every three years" — 
with this conclusion we cannot but 
strongly differ. The inference is given 
that the pupils who decide to enter a 
school giving a two-year course v/ould 
be, or are, of a less desirable character 
than those who enter for a three-year 
course. This inference we most strongly 
resent, just as we have resented in the 



past any inference or statement that 
that the graduates of the smaller hos- 
pitals were less efficient in actual nurs- 
ing practice than those from the larger 
hospitals. The state examinations, as 
far as theoretical and practical tests 
could be made, have shown that in 
neither theory nor practical work were 
the graduates of the smaller hospitals 
behind those of the larger. The very 
fact that the committee states further on 
in its report that "an optional six 
months or third year, if in any way con- 
sidered as replacing a third year of 
regular training, would be objectionable 
for a variety of reasons, and probably 
very few, if any, nurses would take ad- 
vantage of it" — this statement in itself 
shows that the committee believes that 
the vast majority of pupil nurses do not 
consider the third year valuable or neces- 
sary, and would not remain unless 
obliged to do so in order to secure a 
diploma. It is evident from this rea- 
soning that practically all pupil nurses 
belong to this "less desirable class" who 
would like to get through in two years. 
We may safely infer from this that there 
is a vast number of nurse candidates 
outside the hospital who look at the 
matter in precisely the same way, and 
because there is no alternative in many 
schools but to spend the three years, 
they are lost to hospitals that otherwise 
would have their assistance during two 
years. 

With the committee's recommenda- 
tions : "That the three years' course be 
retain^ in all training schools in the De- 
partment of Public Charities which at 
present have such a course with the fol- 
lowing provisions: (a) That there be 
maintained in each school the full quota 
of nurses necessary to properly care for 
the patients, with due allowance to each 



154 



THE TRAINED NURSE AND HOSPITAL REVIEW 



nurse of sufficient time free from ward 
work for study, recreation and vaca- 
tions; (b) That wherever possible the 
facilities for the recreation and reason- 
able comfort of the nurses be improved, 
requests for special additional funds for 
this purpose to be made if required; 
that a full staff of instructors be main- 
tained if necessary, so that too much 
work will not devolve upon the individ- 
ual instructor; (c) That at all times 
such additional graduate nurses be em- 
ployed as may be necessary to provide 
the full quota of nurses to carry out 
thoroughly the provisions of the above 
paragraph" — with these recommenda- 
tions, or at least with the provisos, peo- 
ple in general will be in accord. But 
unfortunately these very desirable con- 
ditions cannot be brought about by pass- 
ing resolutions. "Special additional 
funds" to increase the comfort of the 
nurses do not always come (outside of 
New York, at least) for the askifig. "Ad- 
ditional graduate nurses" are not always 
secured, and retained by a unanimous 
"Aye" in a committee meeting even in 
New York. As a rule graduate nurses 
do not care to spend much time in 
routine ward work. They do it occa- 
sionally till something better is found, 
but they have proven exceedingly un- 
certain supports on which to depend. 

Dr. Wilson, of the Health Department 
of New York City, stated at the Chicago 
convention: "I come from the Health 
Department which employs more nurses 
than any other department in the city of 
New York. We have no training 
school, and we have been confronted by 
our inability to get nurses. to take care 
of our patients — I had six hundred pa- 



tients last Spring, with about forty 
nurses. I am not the only doctor who 
has been confronted by the same thing. 
It was not a matter of pay, as we were 
willing to pay anything to get nurses." 
How much will the provisos affect a 
situation of that kind in New York or 
elsewhere at the present time? 

It is a pretty safe rule to make a prac- 
tice of standing still and making no 
change when in doubt. We are not 
ready for sweeping changes yet. We 
need the changes badly, but we are not 
ready mentally to do the business satis- 
factorily. The committee's report dis- 
poses of the matter for the hospitals con- 
cerned in all probability for some time, 
but the root of the difficulty has yet to be 
reached. How much do we need to 
teach ? When we can come to no agree- 
ment as to that it is hard to agree on how 
long we will need for the work. The 
last word will probably not be said for 
many years on the subject, but there is 
urgent need for hospitals, and all inter- 
ested in the questions involved, which 
affect our hospitals at their most vital 
point, to continue the study of the train- 
ing problem, to approach it with impar- 
tial, unprejudiced minds, regardless of 
whose fads or theories or schemes are in 
danger of being upset. There will 
doubtless have to be another committee 
meeting, and a good many of them, be- 
fore the questions involved are satisfac- 
torily settled. But we have before us the 
hope of evolving a rational system of 
training for nurses that will not impose 
useless and unnecessary bufdens on pu- 
pils or hospitals — something surely worth 
working for. 



parliamentary 3Lato 



Committees — Hozv and Why Formed. 

CORA WELLES TROW. 



ALL committees are formed by the 
organizations requiring their ser- 
vice, and no one can belong to a com- 
mittee who is not a member of the 
organization creating the committee. 

Committees are of three kinds. Stand- 
ing, Special, and Committees of the 
Whole. The Standing Committee is 
usually provided for by the constitution. 
It may, however, be created by the 
vote of the organization. The other two 
committees are always created by ti'C 
vote of the organization, under tiie sub- 
sidary motion to commit. 

It has been said by one of unques- 
tioned authority, that "The committee 
is the eye, and ear, and hand, and very 
often the brain of the assembly. Freed 
from the very great inconvenience of 
numbers,it can study a question, obtain 
full information and put the proposed ac- 
tion into proper shape for final decision. 
The appointment of a committee also in- 
sures to the assembly the presence dur- 
ing the debate of m.embers who have 
made some examination of the ques- 
tion, and tends to preserve the assembly 
from its greatest danger, that of being 
carried away by some plausible ha- 
rangue which excites feeling, appeals to 
sentiment only, and obscures reason.'" 

The work of the Standing Commit- 
tee is defined by its name, it continues 
to serve during the session and termi- 
nates with the annual meeting, unless 
the constitution provides for a different 
term of existence. 

A Special Committee is created to 
obtain information, take iction, give 



advice or confer with some other organ- 
ization. A special committee should al- 
ways be of an uneven number. Unless 
otherwise provided for, the quorum of 
a committee consists of a-' m.ajority of 
the members. Committees must meet 
to act. The Chairman should call at 
least two meetings before a report is 
rendered. If a quorum is obtained 
at the first meeting and all necessary 
business transacted, a second meeting is 
not absolutely necessary, but the Chair- 
man must make at least two attempts to 
obtain a quorum. If she fails, the report 
can be rendered with the statement that 
a quorum could not be obtained. 

The motion which creates a couunit- 
tee should be so framed as to state the 
number of which it should be composed, 
method of its appointment and scope of 
its work. If appointed by the Chair, the 
first person named is usually the Chair- 
man, but not necessarily so. The Chair 
may designate the chairman, or the com- 
mittee may be allowed to choose its own 
chairman. If the appointment of the 
committee rests with the assembly, the 
chairman can be designated by the as- 
sembly. When a committee meets the 
only motions that may be passed are 
suggested recommendations bearing on 
the question under its consideration of 
the work which it has been previously 
decided by the assembly that it should 
be delegated to carry out. 

The reports of all committees should 
be in the shape of a set of resolutions. 
As soon as the report is read, the com- 
mittee ceases to exist, and if the report 



156 



THE TRAINED NURSE AND HOSPITAL REVIEW 



is adopted the assembly thereby agrees 
to carry out whatever it provides for or 
suggests. 

If a committee is divided as to what 
should be the nature of its report, the 
minority may bring in a report differing 
in character from that adopted by the 
majority. The report of the majority 
must be received, the report of the 
minority being received by courtesy. 

All commfttees created by deliberative 
bodies should confine their meetings to 
members only. If outsiders are invited 
for any special purpose, their attendance 
should be confined to such times as no 
business is being discussed. The pro- 
ceedings of a committee are in all cases 
confidential and it is most dishonorable 
to repeat what is said or done in a com- 
mittee meeting. 

The Committee of the Whole is a 
form of procedure little understood b> 
the average assembly. It is a most use- 
ful adjunct to informal discussion and 
one that is well understood by Icg'sla- 
tive bodies. 

When a question is of such a nature 
as to require a very full and free discus- 
sion, the parliamentary rule which al- 
lows a member to speak to a question 
but once is often found irksome. Again 
it is sometimes felt that the discussion 
might be more untrammeled if the pre- 
siding officer were not in the Chair. A 
motion may then be introduced for the 
creation of a Committee of the Whole, 
and, if carried, the presiding officer at 
once relinquishes the meetings to a 
chairman whom she appoints. In a Com- 
mittee of the Whole the members may 
speak as often as they can obtain the 
floor. No action can be taken, but, as is 
the rule in all committees, if the report 
given is adopted, the recommendations 
of the committee become the will of the 



assembly. The origin of the Committee 
of the Whole is as follows: When Will- 
iam and Mary were called from their 
home in Holland to rule over Eng- 
land, William evinced a great interest 
in the doings of the House of 
Parliament and constantly questioned 
the Speaker of the House as to 
the daily proceedings. Many of the 
members looked upon this as the un- 
warrantable curiosity of a foreigner and 
so it was decided that all discussions 
should take place under the semblance of 
a committee meeting. As nothing can be 
repeated which is heard in a committee, 
this obviated the difficulty. 

In the House of Congress all b''ls 
are discussed in the Committee of the 
Whole before the final vote is taken. 

A chairman of a committee cannot be 
invested with any other powers in virtue 
of this position. A chairman of a stand- 
ing committee cannot be made a mem- 
ber of an executive board, although it 
is often very wise to choose the chair- 
man of the standing committee from 
am.ong the members of the executive 
board, no one can become a member of 
that board simply by being appointed or 
elected chairman of a committee. 

A committee is the agent of the as- 
sembly that creates it and the assembly 
is responsible for the acts of the com- 
mittee within the limits of the instruc- 
tions given it by the assembly. Thus, 
if a committee is appointed with full 
powers to arrange for a reception, the 
assembly is responsible for all the ex- 
penses involved in the giving of the 
reception. 

Again, if a committee reports that it 
recommends a certain course of action 
and said course of action should involve 
the expenditure of money, by the ac- 
ceptation of the report of the committee 



THE TRAINED NURSE AND HOSPITAL REVIEW 



157 



the assembly makes itself liable for the 
expense involved. 

Many organizations must from their 
nature carry out the work they un- 
dertake through the agencies of commit- 
tees. When this method is adopted the 
scope and the work intrusted to each 
committee and the power with which it 
is endowed, should be clearly defitied. 

A departmental club differs most ma- 
terially from one whose work is intrust- 
ed to committees, and organizations 
would do well to acquaint themselves 
with the status of these various forms of 
organization. Departments are not com- 
mittees, nor are committees depart- 
ments. 

The power to create or appoint com- 
mittees is one of the most elastic and 
far-reaching of all the powers wielded 



by a deliberative assembly. When a 
matter is referred to a committee, nine 
times out of ten the report of the com- 
mittee is accepted and their recommen- 
dations carried out. A little thought 
will convince any fair minded person that 
in committing a matter great discre- 
tion should be exercised, both as to the 
morale of the committee and the power 
with which it is invested. 

The report of a committee should, if 
possible, be signed by all the members ; 
in any case, the chairman must sign. 
The signature of the chairman is always 
placed at the bottom as a guarantee that 
the signers above are members of the 
committee. If it is thought best to 
have signers who are not members of 
the committee, they sign under the sig- 
nature of the chairman. 




A NATIVK FUNEUAL, MANILA. 
See Ileminlsccnces of an Army Nurse, 



^ensiotifi for armj? JBtutses 



ANITA NEWCOMB McGDB. 

(Concluded.) 



HAVING already considered the 
general subject of pension laws 
for nurses who served under contract 
in the Spanish War, we now take up 
the question of "special" pension acts 
for the benefit of individual nurses. 
To obtain consideration in Congress for 
such a bill it must be proved that the 
nurse is now suflfering from a perma- 
nent form of disability rendering her 
more or less unable to earn her support 
by manual labor. Further, she must 
prove that this disability was incurred 
in the army service, and in consequence 
of it. This it is sometimes quite dif- 
ficult to do on account of proper reports 
not having been made to the Surgeon 
or Chief Nurse. In fact, the chief dif- 
ficulty in the claims lately presented has 
been due to some carelessness on the 
part of the nurse claimant herself while 
in the service, regarding this very inat- 
ter of records. 

Assuming, however, that a case is 
made out as it should hav'e to be for the 
Pension Office if there were a generol 
law, it now becomes necessary to go 
further and enlist the active support of 
the Member of Congress of the district 
where the nurse lives. He will get the 
record of service, honorable discharge 
and illness, from the War* Department. 
Length of service -is not a factor in 
these disability cases, but the Congres- 
sional committees will probably require 
evidence of financial need in order not 
to vote the people's money to one who 
has already means to live comfortably. 
The Pension committees of the Senate 
and House act on these special bills, 



and such as receive their approval be- 
come laws. But unfortunately the House 
Committee is not apt to consider more 
than "one or two claims from any one 
district, no matter how good they may 
be, so influence may be quite a factor. 
Conditions also vary in general from 
year to year, and it would appear that 
the prospect is not so good this year 
as it was last ; though it is hoped that this 
prediction will not be verified. 

The rate of disability pension for 
veterans varies from $6 to $72 a month, 
depending on the character of the wound 
or amount of disability. Of course, 
nurses ought in fairness to be similarly 
rated, but they are handicapped by the 
natural reference to the Civil War nurses' 
rate of $12, to the neglect of the fact that 
that is an age penison only and not one 
for service disability. So far as has been 
learned, only three Spanish War nurses 
are now in receipt of pensions, and the 
rate is $12. 

One of the Camps of the Spanish- 
American War Nurses has raised the 
question of the pensionable status of 
the army nurses since February, 1901, 
when contracts were abolished and the 
Nurse Corps permanently established. 
This Camp passed resolutions maintain- 
ing that legislation for these nurses was 
"superflous" because they "should be 
considered soldiers quite as much as are 
Hospital Corps men," and, therefore, a 
law in the nurses' favor would be "a 
recognition of a distinction that does 
not exist." Uunfortunately for the hold- 
ers of this opinion, it is not in accord 
with either the facts or the law govern- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



159 



ing the case. It is true, however, that 
nurses are now as much a part of the 
army as are Hospital Corps men, but 
here the analogy stops, for there is a 
very great difference between the three 
classes of "commissioned," "enlisted" and 
"appointed." There are a number of 
rights and privileges (including pen- 
sions) which are limited to the first two 
classes, and which nurses would like to 
have, but it must also be frankly stated 
that these rights are linked with i 
number of duties and demands which 
have been quite lost sight of in the 
recent discussions of this question. 
(Probably it would be more correct to 
say that they were never known, at 
least to the ardent advocates of what 
they call "rank" for nurses in the army.) 
To explain what military rank means, 
and why the nurses themselves wov'Jd 
be the first to reject it if all the condi- 
tions were understood, is not appropri- 
ate now, but it may be as well to stite 
that the question is not a new one, but 



that I have yet to find an army n-iise 
who was willing to accept the only con- 
ditions on which "rank," other than at 
present held, could be conferred. 

The Camp above referred to evidently 
learned later some new aspects of the 
case, for after the resolution quotad 
they resolved "to co-operate in any 
measure that will provide the greatest 
good for the greatest number." T'l's 
is just what the Pension Committee of 
the Spanish-American War Nurses is 
trying to do, and it seeks the aid of all 
who are in a position to give it. A 
helping hand is held out by the socie*^y 
to all army nurses, whether of its mem- 
bership or not, whether of '98 or any 
later time. This broad policy ought to 
insure the support of all interested 
persons, and it is hoped that something 
may be accomplished for our sick com- 
rades. Later, by degrees, will come the 
time when the claims of the army nurse 
will secure general recognition. 




A DELIGHTFUL DRIVE IN MANILA. 
See Reminiscences of an Army Nurse. 



fnfant jfeelitng 



MYER SOLIS-COHBN, A.B., M.D. 



Percentage Feeding — (Continued.) 

Soda Solution is made by dissolving a 
teaspoonful of bicarbonate of soda (or- 
dinary baking soda) in a, quart of water. 

Plain Cereal Gruel may be made from 
•barley, wheat, oat or rice flour. This is 
better than using the grains. It is pre- 
pared as follows: Beat up one or two 
ounces (heaping tablespoon fuls) of the 
flour with enough cold water to make a 
thin paste. On this pour a quart of boil- 
ing water and boil for at least fifteen 
minutes. A covered double farina boiler 
is preferable to a saucepan. Add enough 
water to make up what has evaporated. 
Strain while hot through coarse muslin, 
add salt to taste and cool. 

The amounts of fat, proteid and salts 
present in cereal gruel are so small that 
they may be disregarded. The only ele- 
ment of importance is the starch. A 
quart of gruel made with one ounce of 
flour contains ij/^ per cent of starch; 
that made with two ounces contains 3 
per cent. 

Dextrinised Gruel is made in the same 
manner as plain cereal gruel ; but after 
it is cooked place the cooker in cold 
water, and when the gruel is cool enough 
to be tasted add one teaspoonful of 
diastase solution, or Fereo. or ten grains 
of Takadiastase, and stir. Then strain, 
salt and cool. 

Calculation of Modifications — When the 
physician has determined what percent- 
ages of the different elements he desires 
to give, he may calculate the amounts of 
the various ingredients required for his 
modification and then tell the nurse just 
how much milk, cream, sugar, boiled 
water, lime-water, etc., she is to take in 
preparing the bottle. Sometimes, how- 



ever, especially in a children's or infants' 
hospital, he may merely state the per- 
centages he desires to give and leave it 
to the nurse to calculate out the amounts 
of the ingredients required. It there- 
fore is necessary for a nurse to be able 
to make such a calculation. The method 
employed for estimating a top-milk mix- 
ture is different from that used in a milk 
and cream mixture. A nurse should be 
familiar with both. 

How to Calculate a Top-Milk Mix- 
ture. — One must bear in mind that a 
nine-ounce top-milk contains 12 per cent, 
of fat and a sixteen-ounce top-milk con- 
tains 8 per cent, of fat. As both contain 
33^2 per cent, of proteid, the former has 
about three times as much fat as pro- 
teid (3:1), the latter about twice as 
much (2:1). Whole milk contains 4 
per cent, of fat and ^tVi P^i* cent, of pro- 
teid (about 1:1). Kemembering the 
above, with a little thought it is possible 
to make most any modification. If a 3 
per cent, fat and i per cent, proteid mix- 
ture is ordered, nine-ounce top-milk (12 
per cent.) is diluted four times, or i part* 
top-milk to 3 parts diluent. To make a 
2 per cent, fat and i per cent, proteid 
mixture, dilute sixteen-ounce top-milk 
(8 per cent.) four times ; take i part to 3 
parts diluent. A i per cent, fat and i per 
cent, proteid mixture is made by mixing 

1 part whole milk (4 per cent.) with 3 
parts diluent. If the bqttle is to contain 
4 per cent, fat and 2 per cent, proteid, 
take equal parts of sixteen-ounce top- 
milk and diluent ; if 2 per cent, fat and 

2 per cent, proteid, take equal parts of 
whole milk and diluent. A little clear 
thinking will always solve the difficulty. 
Five per cent, sugar is usually desired. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



161 



To obtain this add i part of sugar to 
20 parts of the mixture of food. 

Hozv to Calculate a Cream and Milk 
Mixture. — When cream and milk are 
used the modification can be made more 
exact. By means of an algebraic formula 
any combination of percentages can be 
easily calculated. No thought is re- 
quired. The matter becomes a simple 
problem in mathematics. The following 
symbols are used : 

F = the percentage of fat desired. 

P = the percentage of proteid desired. 

S = the percentage of sugar desired. 

Q =^ the quantity of the mixture de- 
sired, expressed in ounces. 

C = amount of cream required, ex- 
pressed in ounces. 

M — amount of milk required, ex- 
pressed in ounces. 

W = amount of water or other dilu- 
ent required, expressed in ounces. 

L =^ amount of lactose or sugar re- 
quired, expressed in ounces. 

The amounts in ounces of cream, milk, 
sugar and diluent required to make a 
mixture of the desired quantity and con- 
taining the desired percentages are ob- 
tained fom the following equations : 

Q 

Cream (16%*) = — X (F— P) 
12* 

QXP 

Milk =: C 

4 
Diluent=Q— (C + M). 
Lactoses (S — P) X Q 



100 
If the prescription calls for 24 ounces 
of a mixture containing 3 per cent, fat, 
I per cent, proteid and 5 per cent, 
sugar, then 

Q^24 



*If 20 per cent, cream is used, make the 
denominator 16. If 12 per cent, cream is used, 
the denominator must be 8. 



F= 3 
P - I 

S= 5 
To find the amount of cream required, 
substitute in the equations for the sym- 
bols their corresponding numbers, thus: 
24 
C == — (3—1) =2X2 = 4 ounces of 
12 
16 per cent, cream. 

24X1 

]\I ^ C = 6 — 4 ^ 2 ounces 

4 
of milk. 

W = 24 — (4 + 2) = 24—6 = 18 
ounces of diluent. 

(5— 1)X24 4X24 96 

100 100 100 

(practically) 1 ounce of sugar. 

The same method is applied to the fol- 
lowing prescription : Make 16 ounces of 
a mixture containing 2 per cent fat. 1 
per cent proteid and 6 per cent sugar. 
Q = 16 
F - 2 
P - I 
S = 6 
16 

C = -X(2-1) = 1^X1 = V/s 
12 
ounces of cream. 

16X1 

M = lys = 4-1^ = 2^ 

4 
ounces of milk. 

W= 16— (13^ + 2%) = 16 — 4 = 
12 ounces of diluent. 

(6— 1)X16 5X16 80 

100 100 100 

Vr, ounce of sugar. 

The Preparation of the Baby's Food. — 
Enough for one bottle or for the whole 
day may be prepared at one time. It is 
customary to prepare at the same time 
all the bottles of modified milk required 
for the twenty-four hours. This is best 
done on the arrival of the milk and cream 



162 



THE TRAINED NURSE AND HOSPITAL REVIEW 



in the morning, which should be con- 
veniently timed. 

When a milk and cream mixture is to 
be employed the requisite amounts of 
both should at once be measured out and 
mixed in a large sterilized vessel with the 
diluent, in which the sugar should first 
have been dissolved. When nine-ounce 
top milk is to be used the upper nine 
ounces of a quart bottle of milk are re- 
moved by means of an ounce dipper (the 
first ounce to be removed with a teaspoon 
to prevent overflowing) and mixed in a 
pitcher or bowl before diluting. If a 
sixteen-ounce top milk is called for the 
upper sixteen ounces must be removed 
and mixed. If water is used as a diluent 
it should previously have been boiled. 
When gruel is employed as a diluent it 
must be prepared beforehand. When 
soda is added it should be dissolved in the 
diluent. Lime-water when called for 
should be mixed with the milk and dil- 
uent if the food is not to be sterilized. If, 
however, the bottles are to be sterilized, 
the lime-water must be added to each 
bottle just before it is given to the baby, 
as a peculiar chemical reaction occurs 
when sugar and lime-water are boiled to- 
gether. When citrate of soda is em- 
ployed, a solution of this drug in water 
is made containing one to five grains to 
the dram. The amount ordered by the 
physician is added to the baby's bottle 
immediately before feeding. When but- 
termilk is modified with cereal and sugar, 
a smooth paste is first made with the 
flour and sugar and a small quantity of 
the buttermilk, or, when a sugar solution 
is used, with the flour and a small quan- 
tity of the sugar solution. When all 
lumps have been completely smoothed 
out add to the paste the rest of the but- 
temiilk, or the rest of the sugar solution 
and the buttermilk, as the case may be, 
mixing thoroughly. The mixture is then 



heated for ten to fifteen minutes to 155° 
F. or 212*' F., as may be ordered, but is 
never boiled. It is then cooled, bottled if 
possible and placed upon the ice. 

When the milk has been modified the 
bottles, thoroughly cleansed and steril- 
ized, are filled, each with the required 
amount for one feeding. The mouths of 
the bottles are then carefully dried and 
tightly plugged with clean absorbent cot- 
ton. If the food is not to be sterilized 
or pasteurized the bottles are then placed 
at once in the ice chest, where they 
should be kept at a temperature below 
50*^ F. and away from meat or vegetables. 

Sterilisation and Pasteurisation. — 
Sterilization is the killing of all germ life 
by heating the milk to 212" F. or boiling 
it. Pasteurization is heating the milk to 
155° F,, by which the full-grown germs 
are destroyed but the spores or seeds are 
unharmed. 

Many physicians believe that if the 
milk and cream are fresh and uncontam- 
inated, owing to the great precautions 
taken to guard them, the mixture need 
not be sterilized or pasteurized, but when 
prepared should at once be put upon the 
ice. When practicable this seems to the 
writer the preferable method, as such 
heating, especially boiling, not only in- 
jures the nutritive value of the milk, but 
kills helpful bacteria. 

Quite frequently, however, milk con- 
tains large numbers of injurious bacteria 
which must be killed by sterilization or 
pasteurization before it is given to the 
baby. This, of course, is the safer plan, 
being usually more necessary in hot 
weather, especially when it is necessary 
to transport the food a long distance, and 
in the presence of digestive disturbances. 
Some physicians consider some such 
method indispensable as long as sterile 
milk cannot be had with the usual dairy 
habits, as long as it takes a long time to 



THE TRAINED NURSE AND HOSPITAL REVIEW 



163 



get the milk from the producer to the 
consumer, as long as tuberculosis may be 
transmitted, at least now and then, by the 
milk of a tuberculous cow, or, what is 
more frequent, as long as scarlet fever 



and diphtheria are met with in the houses 
and about the clothing and on the hands 
of dairy men and women, and as long as 
typhoid germs are in the water used for 
washing utensils, or for adulteration. 



pneumonia 

ANNIE E. HUTCHINSON. 

(Continued from February.) 



\X7tiEN a nurse assumes charge of 
" * a patient in a private home she 
may find him anything but ideally situ- 
ated as regards ventilation, light, etc., 
and it is incumbent upon her to exercise 
her knowledge, ingenuity and resource- 
fulness (likewise tact in dealing with the 
patient and family who may be opposed 
to radical changes) in making the pa- 
tient's surroundings as favorable as pos- 
sible so as to promote his chances for 
recovery. To have plenty of pure air is 
important under any circumstances, but 
it is particularly so in pneumonia be- 
cause, on account of the rediiced respir- 
atory surface, the patient is suffering 
from a lack of oxygen. So far from 
fresh or even cold air being neces- 
sarily fatal, it is a fact that patients 
suffering from pneumonia — like those 
suffering from tuberculosis — have been 
very successfully treated in the outside 
air even during cold weather. How- 
ever, in most places popular prejudice 
is decidedly opposed to outdoor treat- 
ment for pneumonia, and what is gen- 
erally considered most desirable is a 
room well ventilated but free from 
draughts and kept at a temperature of 
650 F., or perhaps somewhat higher. To 
insure plenty of fresh air one window 



should be kept partly open all the time 
and a screen so placed as to effectually 
prevent any direct draught upon the bed. 
Besides this it is desirable to completely 
change the air of the room every few 
hours — more or less often according to 
its size — and while this is being accom- 
plished the patient should, if necessary, 
be protected by extra covering. If there 
is an adjoining room communicating 
with the sick room, ventilation without a 
direct draught of cold air is more easily 
secured, as the outside air can be al- 
lowed to fill the empty room and thence 
pass to the sick room. If possible, 
the patent's bed should be placed so as 
to be easily accessible from either side 
and so that the light entering does not 
directly strike the patient's eyes — if posi- 
tion of bed does not prevent the latter a 
screen should be used. 
The mattress of the patient's bed should 
be protected by rubber sheeting and the 
bedclothes should be sufficient to give 
necessary warmth, but not too heavy. 
Too much covering is Hkely to render 
the patient more uncomfortable and also 
retains' exhnlations from the body. A 
plain, loose flannel gown, made so as to 
readily permit local applications and 
examinations of the chest, is a very desir- 



164 



THE TRAINED NURSE AND HOSPITAL REVIEW 



able garment in pneumonia. Cough, 
repressed more or less on account of 
the severe pain it causes, is usually an 
early symptom of pneumonia. The 
expectoration, which at first may be 
scanty, frothy and tinged with blood, 
later is likely to become more profuse, 
viscid and very tenacious, while its color 
varies from a light yellow or perhaps 
greenish to a rusty or dark brown. Oc- 
casionally the sputum is thin and dark 
colored — sometimes termed prune juice 
sputum — generally regarded as a 
specially unfavorable symptom. The 
characteristic expectoration of pneumonia 
is extremely adhesive and the nurse 
should have provided an abundance 
of clean cloths which may be used to aid 
removal. These should be promptly 
burned after using before they have an 
opportunity to get dry. Some of the 
sputa should be preserved for the doctor's 
inspection. The characteristic respira- 
tions of pneumonia are rapid and shal- 
low, their frequency, if consolidation is 
extreme, being out of all proportion to 
pulse and temperature. This is not only 
due to the reduced respiratory surface, 
but partly also to the pain which pre- 
vents a full respiration. Respirations 
may be as high as 40 or 50 or probably 
60 per minute. If respirations are very 
high and the fever moderates they have 
a graver significance than when the fever 
is high. 

Not only should chills, pain, tempera- 
ture, pulse and respirations, cough and 
expectoration be carefully noted, but 
also the hue of the face, any coldness of 
the extremities, the condition of the 
skin, the mental condition and also any 
evidence of nervous disturbances, such 
as extreme prostration, shaking limbs, 
tremulous tongue, aching bones, etc., 



also, as in other cases, the condition of 
bowels and urine. 

As a rule the face is inclined to be 
pale or of a dusky hue, with, perhaps, 
red patches on the cheeks. The dark 
hue is more or less pronounced in pro- 
portion to degree of respiratory involve- 
ment, and in severe cases the lips gen- 
eral take a bluish tint. As the danger 
depends considerably upon the extent to 
which the lungs arc involved, the hue of 
the face is significant. 

At first the skin is generally hot and 
dry; later there is often a tendency to 
perspiration, wliich may become pro- 
fuse. The urine is generally scanty and 
frequently contains albumen. 

Delirium is frequently present and is 
not always dependent upon or in pro- 
portion to the temperature. It is an un- 
favorable symptom, but has not as seri- 
ous a significance if it occurs early in 
the disease. If present when fever Is 
moderate it is a graver symptom than 
when fever is high. Old persons are 
liable to a quiet delirium resembling that 
of typhoid. All penumonia cases re- 
quire vigilant care, but when delirium is 
present their condition calls for special 
watchfulness. In pneumonia, especially 
in alcoholic patients, the delirium is apt 
to assume a sudden frenzy when the 
patent may exhibit unexpected violence 
and very likely attempt to spring from 
bed. If not attentively watched the pa- 
tient may actually leave the bed and prob- 
ably attempt to spring from a window or 
do something else equally dangerous. 
When one nurse is in charge of a de- 
lirious pneumonia patient, she will do 
well to avoid risks by invariably call- 
ing in some member of the family to 
watch the patient whenver she is obliged 
to leave the room. • A case came under 
the writer's own observation — being 



THE TRAINED NURSE AND HOSPITAL REVIEW 



165 



called in as special nurse afterwards — 
where a young man suffering from 
typical pneumonia, in a frenzy of deli- 
rium during high fever, succeeded one 
night, not only in leaving his bed and 
the ward where he lay, but the hospital 
building and grounds, aftenvards run- 
ning in bare feet, and clad only in cot- 
ton night gown, for about a mile over 
the frosty ground — it was in January. 
Fortunately and, as it was considered, 
miraculously, this particular patient 
seemed to suffer no ill effects. The 
crisis came within twenty-four hours 
and he made a rapid fe^nd complete 
recovery. 

During the fever stage of pneumonia 
the patient should be given only liquid 
diet, preferably milk, which if not read- 
ily digested may be peptonized or it 
may be given in the form of kumyss. A 
steady milk diet is very monotonous 
and, as a rule, it is advisable to vary it 
somewhat with beef tea or expressed 
beef juice, or the doctor may order pan- 
opepton or some other of the reHable 
patent food preparations. It must be 
borne in mind that the febrile condition 
is very unfavorable to digestion and the 
nurse must be careful not to give her 
patient more food than he can digest. 
The mere swallowing of food will not 
serve to keep up the patient's strength, 
and to crowd nourishment may do a 
great deal of harm by causing indiges- 
tion and consequent flatulency. Forty 
ounces of nourishment in the twenty- 
four hours is generally considered a 
fair amount in the average case. Usual- 
ly the doctor will give instructions as to 
amount and kind of diet, and if so, the 
nurse will be guided by these. Water is 
not considered harmful and patients 
may, as a general rule, have as much as 
they desire. 



The treatment of pneumonia varies 
considerably with different doctors; 
however^ the nurse is only required to 
faithfully follow the particular line of 
treatment adopted in each case. Sponge 
baths or cold packs may be ordered to 
reduce the fever, and probably also for 
their soothing influence upon the ner- 
vous system. The cold sponge bath in 
pneumonia should not, as a rule, last 
more tlian ten minutes. A good effect 
is generally obtained by accompanying 
the bath with brisk friction which stimu- 
lates the circulation and produces reac- 
tion and perspiration. In giving a cold 
sponge bath or cold pack be particular 
to ascertain from the physician the tem- 
perature of the water to be used. In giv- 
ing a cold pack, the desired reaction may 
be produced by covering the wet towels 
or sheet with a blanket. Ice poultices 
or ice bags, also hot flaxseed poultices 
and numerous other local applications, 
are employed. If hot poultices are 
ordered — and in some places, at least, 
they have not gone entirely out of fash- 
ion as pneumonia treatment — they de- 
mand much care and attention on the 
part of the nurse, as they may do more 
harm than good if not changed carefully 
and frequently enough. 

Sleeplessness is not uncommon in 
pneumonia, but, on the other hand, more 
particularly as the disease progresses, 
there may come a drowsiness of somno- 
lence that is liable to deepen into coma 
— if the patient's condition indicates any 
probability of this danger, efforts should 
at once be made to rouse him. If ordi- 
nary means fail, sponge face, neck and 
between shoulders with cold water. 

Many conditions, such as the presence 
of some previous chronic disease, 
previous habits of the individual, season 
of year, age and sex, modify the progno- 



166 



THE TRAINED NURSE AND HOSPITAL REVIEW 



sis in pneumonia. The death rate is pro- 
portionately higher in Autumn and 
Winter, in the aged and in women. In 
diabetic or rheumatic patients, in those 
suffering from chronic nephritis or from 
cardiac disease, the prognosis is always 
unfavorable. But, however unfavorable 
the prognosis, the nurse must diligently 
and faithfully attend to her duty, hoping 
always for the best. Recoveries some- 
times occur after all hope has almost 
been abandoned. 

The nurse should, of course, keep for 
the physician a faithful record of all 
treatment given, diet, temperature, pulse 
and respirations, cough and expectora- 
tion (frequency and characteristics), 



urine, defecations and everything that in 
any way marks the patient's condition 
or progress. 

^Pneumonia is not generally thought 
of as being among the infectious dis- 
eases, and it is certain that it is not 
readily transmitted from one person to 
another. It is, however, communicable 
under very favorable conditions, as has 
been proved by well authenticated in- 
stances. Although under ordinary cir- 
cumstances there is little danger of 
communicaton, it is, nevertheless, wise 
for the nurse to adopt all precautions 
that do not interfere with her full duty 
to the interest of her patient. 




fm 




Ji 



ARMY NURSES IN MANILA IN NATIVE COSTUME. 



Btspensarp Woxk 



A. M. N. 



HAVING had the good fortune to be 
asked to serve as dispensary 
nurse in a private dispensary in the 
midst of the most densely populated dis- 
trict of Boston, I thought a brief history 
of the daily work would be of interest 
to some of the readers of "The Trained 
Nurse." 

I had been doing private nursing for 
three years; through the resident physi- 
cian I was asked to take up this work for 
six months. The experience is unlimited. 
We all know that in private work we 
have little or no occasion for diagnosis. 
In this work the opportunity is unlimited. 
Also in hospital work the case is already 
diagnosed when we receive it. 

Now to give a brief outline of the 
work as it is carried on at our dispen- 
sary : — 

The daily clinic opens at 10:30 A. M. 
when the medical, surgical and special 
clinics are open to the district. Usually 
there is a waiting line outside the door 
by 10 o'clock, men, women and children. 
When the door is open, they file in, re- 
ceive their checks, which cost them loc. 
With each check, goes the number they 
represent. First come first served. 

First, a woman with a bad cough — 
history taken and preparations made to 
watch for tuberculosis. Next, a boy to 
have his eye treated ; then, a man for a 
new dressing for a fractured arm; next, 
a girl to have some teeth extracted, and 
so it goes down the list. 

Sometimes twenty and more are to be 
treated. At 12:30 the door is closed, 
and any outside calls that come in are 
noted to be attended to after 3 P. M. 

After 3 the physician and the nurse 



start out for the calls. New cases first. 
We climb long, dark stairways, to find a 
girl ill; case looks suspiciously like ty- 
phoid. Leave directions and will make 
a call in the morning, for the morning 
temperature. Then to a case of delirium 
tremens; next to a leptic hand, etc. 
Then the old cases — little Willie ill with 
pneumonia, restless and very ill. (This 
case finally is diphtheria). Children all 
say "Good-bye, doctor; good-bye, nurse; 
you can make our brother well, can't 
you?" Then to a tonsilitis case, and 
two calls on confinement cases. 

When all are made it is 6 P. M. 

Preparations are now made for dinner 
when bell rings and voice at the tube 
says : Doctor, I must see you ; my hand 
is so bad." Woman with septic fingers. 
She is taken into surgery, instruments 
and dressing prepared; hand is cleaned, 
and wet dressing of bichloride put on; 
then when all is ready finger is lanced 
and dressed, and woman leaves happy. 

We then scrub up and go to dinner. 
Return 8 o'clock, find a call to go to a 
confinement case — in a hurry — rush. 
Deliver the woman; wash and dress the 
baby; the nurse having carried the baby 
clothes with her and a fresh gown for 
the mother — sometimes they are needed. 
All is quiet by 1 1, when the nurse goes to 
her room, ready to start at any mo- 
ment. 

This is a brief outline of one day's 
work. 

Some days we send two or more cases 
to the hospital. We have many cases of 
appendicitis; by prompt and correct 
diagnosis and early surgical treatment at 
the hospitals their lives are saved. 



168 



THE TRAINED NURSE AND HOSPITAL REVIEW 



The dispensary provides baby clothes 
for the very needy, as previously noted ; 
also milk and eggs in many cases. The 
.patients who are "out" patients — those 
treated at home — expect to pay 15c. a 
call. And the dispensary expects that all 
cases will pay something, though there 



is no limit as to charges. Nearly all can 
pay something, and usually do so gladly. 
It is most interesting work and a great 
opportunity for broadening our profes- 
sion. Each day contains many new ex- 
periences, and when night comes we can 
say "well done." 



practical g^usgestionfi for JBturses 



GRACE B. HOMMAX. R.N. 



1. When giving turpentine in cap- 
sules, if the cap is quickly (lij)ped in 
water before putting together the turpen- 
tine will not leak out. and so will not be 
tasted. 

2. In making rectal examination it is 
advisable to first put soap under the 
finger nails. 

3. When handling plaster paris use 
vaseline on the nails. 

4. Line basins in which plaster paris 
bandages are to be soaked with brown 
paper, as afterward the water may be 
poured off, leaving the sediment, which 
can then be easily disposed of. It is 
advisable to change the water often anvl 
to keep a small amount of salt in it. 

5. It is a good plan to save brown 
paper to line basins used for soiled 
dressings. 

6. Save paper bags for soiled dres.s- 
ings. 

7. Applicators can be much more 
easily wrapped if the cotton is taken 
lengthwise of the roll, as the cotton 
fibres are longer. 

8. Dressings once sterilized need not 
be re-sterilized if wrapped in waxed 
l)aper. 

9. When a patient is so nervous that 



the click of the latch in opening and 
cl<ising the door is very annoying wrap 
gauze around the handles, bringing it 
over the latch. The door may then be 
opened or closed without a sound. 

10. Dressings will not adhere to burns 
if gutta percha is used next the wound. 
First perforate it so that the discharge 
can come through. For this purpose use 
a conductor's punch, placing tissue be- 
tween the gutta percha, as it can then 
be more easily punched. 

11. It is easier to give medicine to a 
baby if the spoon is held in the mouth, 
holding the tongue down; the infant is 
compelled to swallow, 

12. Patients who complain of diffi 
culty in swallowing pills and capsules 
often have no trouble if the medicine is 
placed under the tip of the tongue and 
then water is given them to swallow. 

13. When an air cushion is uncom- 
fortable to a patient partly fill two 
water bags with warm water and slip one 
under each hip. 

14. To cover an air cushion take a 
cheesecloth bandage 2}4 to 3 inches wide 
and wrap it around and around the 
cushion, allowing the edges to overlap. 
Then baste the ends together. When 



THE TRAINED NURSE AND HOSPITAL REVIEW 



169 



the bandage is soiled wash, and while 
wet wrap around a large bottle and set 
in the sun or a warm place to dry. It 
can then be rolled and is again ready for 
use. 

15. Do not boil rubber tubing with in- 
struments, as it discolors and corrodes 
them. 

16. For the same reason use carbon- 
ate of soda instead of bicarbonate when 
sterilizing instruments. 

17. In an emergency instruments can 



be quickly sterilized by pouring alcohol 
over them and setting fire to it. 

18. When hot fomentations arc re- 
quired it is much easier and makes the 
hands less tender if the cloths are first 
wrung out of water and are then put in 
a steamer (or colander with lid), and 
are steamed. By this method they arc 
always ready for use. It is occasionally 
necessary to moisten the cloths as they 
become dry. If turpentine is required 
a few drops may be rubbed" in the cloths. 



Legislation for Nurses 



Several legislative matters bearing 
upon nursing have come up since our last 
issue. Probably the most important is 
the agitation for the employment of 
women nurses in the navy. This was 
given official expression January 29 by a 
bill introduced in the House by Mr. Bur- 
ton, of Delaware. The bill authorizes 
the Surgeon-General of the Navy to ap- 
point, under regulations prescribed by the 
Secretary of War, women nurses for the 
navy, as follows ; One superintendent 
and as many chief nurses, nurses and re- 
serve nurses as may be needed, all to be 
graduates of hospital training schools 
whose course is not less than two years. 

The term of ai)p()intment, according to 
the bill, shall be tliree years, and the ap- 
pointment may be revoked at- any time, 
"should the interests of the service re- 
quire." 



Senator Travis, of New York, has in- 
troduced a bill including nurses in the 
class with undertakers, which entitles 
them to collect their bills at the end of 
sixty days. Under the present law nurses 
are common creditors, and it frequently 
happens that a nurse has to wait a num- 
ber of months for the settlement of an 
estate before receiving her pay. 

Assemblyman Harper, of New York, 
who has introduced a bill to increase the 
salaries of nurses and attendants attached 
to State hospitals about 25 per cent, 
states that he will press the measure to 
passage. A definite scale of salaries is 
provided in the bill. 

A Rhode Island judge has rendered a 
decision that a trained nurse cannot be 
classed with domestics, but is rather one 
who renders personal services to an em- 
ployer in an independent calling. 



Personal 



Miss Efifa Griffin of Oakland, Cal., a grad- 
uate of the National Temperance Hospital in 
Chicago, and Miss Mary A. Hagan of San 
Francisco, Cal., formerly at the General Hos- 
pital of .San Francisco and Southern California 



State Hospital, have gone to the Pennsylvania 
Orthopaedic Institute and School of Mechano- 
Tlierapy, Philadelphia, for instruction in the 
Swedish system of massage, gymnastics, elec- 
tro- and hydro-therapy. 



3Remtniscences of an Cy^armp JBiurse 



CECILIA McHUOH. 



THE army nurse corps offers a favor- 
able and highly increasing field for 
the graduate nurse who prefers institu- 
tional work to private nursing and to the 
nurse imbued with a desire to study human 
nature at close range. If she be blessed 
with a goodly share of humor (the sav- 
ing wedge of many a hazardous situa- 
tion), there is, to my mind, nowhere else 
where work and pleasure can be com- 
bined with greater interest and profit to 
the worker than in the ranks of the A. 
N. C. I believe it will be conceded by 
all army nurses who have had a wide 
experience with sick human nature that 
as a patient the soldier boy cannot be 
beaten, while his witty remarks apropos 
current topics and passing events in 
the ward would serve as a tonic to the 
most jaded intellect. Here you have the 
unsophisticated boy from the farm, 
whose original and unbiased comments 
on the doings of his superior officers, or 
whose frank criticisms of his "bunkies" 
are in striking contrast to the cynical an 1 
almost always querulous complaints of his 
blase comrade who has sought relief in 
the possible excitement of a Philippine 
campaign for the wounds sustained in a 
conflict with life's grim realities. Then 
you have the dear old soldiers — those 
nearing. or already claiming veteranship, 
who are always a delight and special 
care to the nurses — though their long ex- 
perience of "roughing it" makes special 
care unnecessary. So appreciative are 
they of the ordinary comforts of modern 
military hospitals that they never cease 
contrasting conditions in their time an:l 
now for the benefit of any of the 
"rookies" who are inclined to find fault 
with present conditions. 



To the uninitiated the army nomencla- 
ture is as unintelligible as Greek, though 
once you get "on" you find it much more 
expressive than plain ordinary English, 
^nd soon find yourself making use of it 
with the ease of a sergeant-major. Apart 
from the work and its attendant pleas- 
ures or vexations, the A. N. C. offers 
unusual opportunities to the nurse who 
likes to travel, and if she avail herself, 
of all the opportunities she has in this 
direction she can revel in the grandly 
inspiring luxury of two of the greatest 
and grandest works of nature we have 
here in America, besides being enabled to 
see California and do its many places of 
interest pretty thoroughly. The two great 
wonders referred to are the Yosemitc 
Valley and the grand canyon of Arizona. 
Then there is the trip to the Orient which 
she cannot fail to accept in the light of a 
liberal education in itself, and of which 
this article will treat. Whatever 
pangs of homesickness she may feel on 
passing out the Golden Gate and leaving 
beautiful California behind, or, whatever 
misery she may suffer in the way of sea 
sickness, all is forgotten as soon as she 
sets foot on solid earth at Honolulu and 
engages in the rush to take in all the de- 
lights of that beautiful spot. H she is 
lucky enough to have any friends or ac- 
quaintances there it will be doubly inter- 
esting for her — besides affording her an 
opportunity of partaking of the native 
dish — poi and dried fish — which is con- 
sidered the piece de resistance to a resi- 
dent of Honolulu. From the fact that 
many Americans relish it, it would seem 
that it is possible to cultivate a taste for 
it, but to the newcomer it resembles a 
sand pie, and the taste is nondescript. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



171 



To see both Americans and natives scoop 
up the soft mass with their index finger 
and convey it to their mouths with the 
greatest dexterity seems like going back 
to first principles. 

Of course, every one wants to attend 
the dance usually given at the Royal 
Hawaiian Hotel for the passengers off 



present a scene which must be witnessed 
to be fully appreciated — and then your 
appreciation will be beyond expression. 
Next day she must surely take in the de- 
lights of surf bathing at Waikiki. 

Of course, no one will willingly miss a 
visit to the Pali, immediately back of the 
harbor and citv of Honolulu. It is 




THE NURSES' HOME, MANILA. 



the transport; but to those unwilling or 
unable to dance, the concert of quaint 
and delightfully entertaining native songs 
and music given in front of the hotel, the 
tropical beauty of the grounds, supple- 
mented by myriads of vari-colored elec- 
tric lights, Japanese lanterns, festoons 
of the beautiful and fragrant flowers, 



reached by an hour's drive of six miles 
to an altitude of 1,200 feet over one of 
the most perfect of roads. From be- 
tween a glorious amphitheatre of perfect 
walls the visitor is suddenly ushered to 
the verge of a tremendous precipice over- 
looking a broad landscape of green plan- 
tations at the foot of a lofty precipice. 



172 



THE TRAINED NURSE AND HOSPITAL REVIEW 



This is bounded beyond by the fretted 
blue Pacific and at the north by wild 
broken ridges which kindle a desire to 
explore. An excellent road is carved 
down the precipice and continues along 
the coast for thirty miles, until it meets 
the railway. For the benefit of those 
not familiar with the gruesome legend 
of the Pali, I will quote the following: 

"In the year 1795 Kamehameha the 
First, King of Hawaii, in pursuance of 
his policy of uniting the whole Hawaiian 
group under his sway, came with an im- 
mense army to war against the King of 
Mani and Oahu. Kamehameha landed 
at Waikiki, the now favorite seaside re- 
sort — his immense fleet of canoes occupy- 
ing the beach from Waikiki to Wailae, 
to the windward of Diamond Head. Sev- 
eral running engagements took place be- 
tween the opposing forces. Finally the 
hostile forces met in a pitched battle at 
Puiwa, about two miles away from the 
sea. The army of Kamehameha gradu- 
ally gained the advantage and pursued the 
enemy further and further up the valley 
until finally they were driven over the 
precipitous pali — thousands there meet- 
ing death — those that were slain or 
wounded en route being also hurled 
over." 

The giving of leis to departing friends 
is a very pretty Hawaiian custom. Leis 
are a chain of flowers made from the 
beautiful native flowers, or beads, and 
are worn by the women around the neck 
and by the men on their hat bands. 
Those made from the flowers of the na- 
tive plant, mallot, retain their fragrance 
in your state room until you reach 
Manila. As the transport leaves the 
wharf to the strains of "Good-by, Little 
Girl, Good-by" and "Home, Sweet 
Home," played either by the regimental 
band on board or the Hawaiian band on 



the pier, the admonitory advice of "Don't 
Cry, Little Girl, Don't Cry," goes un- 
heeded as you realize that you are 
severing the last link that connects you 
with the Occident, and as the 
natives, your friends and interested 
spectators throw hundreds of leis on the 
water, it certainly is a touching and 
pretty sight to see all the good wishes in 
the form of flowers floating out after 
the transport as it reluctantly pulls out 
for its two 'weeks of uninterrupted isola- 
tion on the briny deep. 

If you are inclined to be seasick, of 
course you will not have much pleasure 
on the trip, and will hail with overflowing 
thankfulness the little Island of Guam, 
with its limited possibilities for relaxa- 
tion or recreation. It is customary for 
the Governor of the island to have all 
available conveyances — carriages, ambu- 
lances and caribou carts — down at the 
pier awaiting the passengers ofl^ the trans- 
port to convey them to Agana, the capi- 
tal of Guam. It is also the naval station 
and the Governor's seat. This courtesy, 
as well as the serving of a most deli- 
ciously appetizing luncheon to all passen- 
gers at the palace, is a self-imposed task 
on the Governor which I am afraid is not 
fully appreciated. After luncheon the 
Governor and staff and all American la- 
dies on the island, of which there were 
only five the day we were there, take you 
sightseeing through the town. The school 
and a frightfully dilapidated old Spanish 
church. 2(X> years old, were the only ob- 
jects of interest there. You probably 
never before thought very highly of ma- 
rines, but when you see them here on 
this isolated little island, in their immac- 
ulately white suits and charmingly polite 
and deferential manner, with unmistak- 
able signs of welcome in their looks and 
actions (such signs of welcome probably 



THE TRAINED NURSE AND HOSPITAL REVIEW 



173 



engendered more by the arrival of the 
monthly supply of fresh meat and other 
supplies from the transport than from 
your presence there), you find your loy- 
alty to the soldier boy wavering and con- 
clude that it would be impossible to find 
such another body of well-drilled men. 
The five days from Guam to Manila 
passes very quickly, owing to the excite- 
ment and expectancy incident to the 
nearing of the San Bernardino Straits. If 
you are interested enough you will find 
yourself on deck at 4 a. m. admiring 
Jupiter and the Southern Cross and 
awaiting daylight and the most beautiful 
of sunrises, and as you pass up between 
the islands of Samar and Luzon you can- 
not fail to be favorably impressed with 
the tropical beauty of it all. Having 
gone through the necessary preliminaries, 
you disembark and are conveyed by am- 
bulance, or, if your friends are at the 
dock awaiting you, they will treat you to 
your first ride in the fascinating carro- 
mata to the nurses beautiful home on 
Calle General Solano, over which you are 
very enthusiastic. Having been duly 
welcomed by some more of your previ- 
ously arrived friends and by dear old 
Soledad — the nurses' Filipino mascot — 
and having the innerman attended to by 
the ever-faithful and amiable old John 
Chinaman, your next treat will be a drive 
to the Luneta, the surprise and delight of 
all visitors to Manila. The scene on the 
Luneta is very fascinating at all times, 
but of course much more so to the re- 
cently liberated passenger who has spent 
four weeks on a crowded transport. The 
delight of this freedom is enhanced by the 
after glow of a most beautiful sunset, re- 
flected on Manila Bay, with a fine band 
discoursing the latest American airs to a 
highly cosmopolitan and apparently ap- 
preciative audience. The Constabularv 



Band, composed of natives, with an 
American negro as leader, plays here 
three or four times a week; some regi- 
mental band playing the remaining even- 
ings. 

Every one in Manila seems to be in 
evidence at these concerts. The Ameri- 
can women, with their pretty, lacy cos- 
tumes ; the evidently prosperous and ap- 
parently pompous Chinamen, the Arabs 
with their bright colored headgear, the 
Japanese with their peculiar form of 
dress and the native Filipino, whose cos- 
tume, consisting in some cases of a bright 
red, purple, green or blue camisa 
(shirt) and pants or skirts of either one 
of the above-mentioned colors, and whose 
airiness and transparency are so pro- 
nounced as to leave nothing to the imag- 
ination, and, last but not least, the Ameri- 
can soldiers and sailors who make up the 
standing audience, and whose attitud'e of 
respectful attention (standing bare-head- 
ed, with right hand across heart) during 
the rendition of the closing number, the 
"Star Spangled Banner," is invariably 
emulated by all the native men and boys, 
all contribute to the intense picturesque- 
ness of the scene. At the close of the 
concert, after a delightful drive on the 
Malaccan or out Santa Ana way, you re- 
turn to the Home and find yourself 
thinking: 

"How great would have been your bliss, 
If Heaven had but assigned you, 
To live and die in scenes like this, 
With some you left behind you?" 

However delightful, I assure my 
friends that I have not yet heard the 
"East-a-calling." I must add that after 
a few years of this continuous and en- 
ervating heat and gayety you begin to 
tire of it and think longingly of those 
delightfully invigorating Autumn days 
spent somewhere East of the Rockies. 



Cfje jfounliltnff Slfiplum in ^Florence 



8. D. H. 



DURING the Summer of 1902 it was 
my good fortune to spend a few 
most charming days in Florence — days 
ever to be remembered, as those of my 
readers who have chanced to go that 
way well know. A little while in Flor- 
ence means that one can feel somewhat 
the influence of the place, so filled with 
many of the greatest art treasures of the 
world. 

One is fairly dazed with admiration 
from the moment you find yourself with- 
in that old Italian city, almost forgetting 
the present, and living in the past, as it 
were, during the enchanting hours spent 
among its varied works of art. 

Among the many attractive works of 
Andrea della Robbia, the famous master 
in clay, are the Innocenti medallions, 
which form part of the facade of the old 
Foundling Hospital. 

These wee babes in swaddling clothes, 
moulded in material which has stood for 
several hundred years, have a great 
fascination for the traveller, and as one 
approaches the gray and dingy building 
on the Piazza dell' Annunziata the 
first impression of these tiny creatures, 
all along the wall, is pleasing, indeed. 
This great shelter for the destitute and 
unfortunate little ones has long held 
an attraction for many a visitor in Flor- 
ence. 

One bright, sunny morning, such as 
one usually finds in September in Italy, 
my friend and I turned our steps toward 
the old hospital. Entering a court by 
way of an archway in the wall we were 
asked to wait there until a guide was 
sent to us to show us all about. As we 
were standing but a few feet from the 
chapel door, over which is a lovely 



Annunziata by Andrea della Robbia, wo 
were able to study the sweet faces of 
that famous work, which surely is well 
worth time and pains to see. 

While we were thus standing, quite en- 
raptured, an attractive little nun ap- 
peared, who was to take us through the 
institution. 

As we followed our little simple guide 
I could not helo drawing a contrast be- 
tween the old and reeking walls, so im- 
pregnated with the dust and microbes of 
ages, and our great modern sanitary 
buildings. 

One hates to dwell upon such thoughts 
while there, but afterward we cannot 
help feeling how much more science has 
done for us — and money, too — for truly 
one sees poverty in Italy. 

This part of the hospital is exclusively 
for the babies, the maternity buildings 
being on the opposite side of the piazza. 

When a child is but a few days old — 
yes, and often but a few hours in this 
world — it is taken over to this great 
home. The poor little creatures are 
many a time left alone on the doorstep, 
to be kindly cared for by the Sisters. 
These wee mites of humanity, the Sister 
said, sometimes are born in the very 
street. 

Poor, forlorn miserable little waifs — 
how little life holds out to many of them. 
Few may fall to a better lot, but many 
are sooner or later cast upon the great 
world. We were taken into one large 
room where in the middle stood a large 
table, about six feet square. This was 
covered with an unattractive looking 
black oilcloth, over what may have been 
a mattress, or any other soft and bumpy 
lining. This, the Sister said, was where 



THE TRAINED NURSE AND HOSPITAL REVIEW 



175 



they changed the babies and did the sur- 
gical dressings. Fancy such a combina- 
tion in our days of enHghtenment ! To 
a native Florentine all that sounded clean 
and nice ; to us it seemed quite different. 

We passed along the various halls, 
were shown the closets where the linen 
was kept. 

We finally came to a small room, 
where we saw a buxom mother nursing 
two babes, one at each breast. Think 
of that wealth of nourishment in one 
poor, forlorn Italian woman, where in 



our land of luxury so many of the richer 
born are bound to struggle for life over 
the nursing bottle. 

According to their idea of cleanliness 
all was very nice, and I feel grateful to 
the little Sister for all her kindness and 
interest in taking us about their home. 

Surely I never shall forget it, and if 
ever again I am fortunate enough to 
visit Florence I shall certainly want to 
go to the hospital, if only to see whether 
in that old city time has done anything 
toward the advancement of sanitation. 




/ 5' 




UN INNOCBNTA, 
ANDREA BELLA ROBBIA. 



Personal. 



Miss J. Augusta Briggs, formerly superin- 
tendent of the Cambridge Training Scliool 
for nurses, has been appointed principal of 
the Training School for Nurses and matron 
of the Framingham, Mass., Hospital. 



Dr. Annie Hintze, who succeeded Miss 

Annabelle Stewart as superintendent of the 

Framingham Hospital, tendered her resigna- 
tion some months ago. 



Obituary. 



It is with deep sorrow that we announce 
the death of Miss Bertha Kaschell, a pupil 
nurse of the German Hospital, Brooklyn, N. 
Y. She died of typhoid fever on January 21, 
1908. While she had been in the training 
school only six months, her work was charac- 
terized by earnestness of purpose and devo- 
tion to duty which stamped her as one of the 
bright lights of the school. 



Mrs. Bina Wiley Morgan died at the home 
of her brother, Mrs. Wm. Wiley, 708 East 
Jackson street, Pana, 111., on June 8, 1907. 
Mrs. Morgan was a graduate of the West 
Philadelphia Hospital for Women, of the 
class of 1904. It is with deep regret that her 
classmates learn of her death. 



JBeparttnmt of ^rm^ i^ur0iua 



DITA H. KINNEY 
SuperintendeDt Army Nurse Corps 



THERE have been five discharges 
since the last army notes: Clara 
C. Doersch and Bert D. Brackett in San 
Francisco, Mona E. Martin and Eliza- 
beth D. Thomas in the Philippines, and 
Sara Burtiss Myer from Fort Bayard. 

The appointments have been : Mrs. 
Louise De Pue Maguire and Miss Grace 
Helen Nutter, graduates of the National 
Homeopathic Hospital, Washington. D. 
C, in 1906 (Mrs. Maguire has also had 
six months' experience in charge of Dr. 
J, E. McQuain's Hospital, at Spencer, 
Va., and Miss Nutter nine months in 
the Portland, Me., General Hospital) ; 
Jane G. Molloy, graduate of the City 
and County Hospital, San Francisco. 
1907; Elma Baker, graduate of St. 
Joseph's Hospital. Hot Springs, Ark., 
1907. All of these appointees were as- 
signed to duty at the General Hospital, 
Presidio of San Franci.sco. 

A cablegram from the chief surgeon, 
Philippines Division, announces the re- 
appointment of Emma Haefner, who 
was discharged at her own request in 
Manila, to take charge of a railroad hos- 
pital there. Miss Haefner requested re- 
appointment in the Army Nurse Corps, 
having found that civil positions did not 
afford a sufficient amount of rest and 
free time demanded by work in the 
tropics. 

Another reappointment has been given 
to Bertha Purcell, an ex-army nurse, dis- 
charged at her own request last May. 
She also is assigned to duty at the Gen- 
eral Hospital, Presidio of San Francisco. 



Nurses Hannah A. Kallem, Lydia M. 
Keener, Ella B. King and Elizabeth D. 
Reid, having completed their tour of 
duty at Fort Bayard, have been trans- 
ferred to General Hospital, Presidio of 
San Francisco. They have been re- 
placed at Fort Bayard by Grace E. 
Leonard. Evelyn E. Mericle, Madeleine 
M. Pampel and Minnie E. Schreiber. 

The transfers in the Philippines have 
been: Adelaide Duncan and Clara L. 
Postlewait, from Zamboanga to Camp 
Keithley; Minnie A. Philippens, from 
Camp Jossman, Guimaras. to Military 
Hospital, Iloilo, Panay, and thence to 
the Division Hospital, Manila; Clara M. 
Selover, from Zamboanga for special 
duty at Jolo Jolo. P. I. ; Agnes Astbury, 
from detached duty at Jolo Jolo, to 
Zamboanga. 

Mabel D. Gee and Hannah P. Morris, 
recently arrived in Manila, were assigned 
to duty at the Division Hospital ; Alice 
Cecil White, transferred from Fort Mc- 
Kinley to the Division Hospital ; Sarah 
M. Hepburn, from Camp Keithley to 
Zamboanga. 

A nurse recently arrived in Manila 
from the Ignited States writes of her 
trip and first impressions : "Despite 
much that was disagreeable, the trip 
aflForded so man-y pleasures that the un- 
pleasantnesses are already forgotten. T 
am agreeably disappointed to find Manila 
still unspoiled (if I may so express my- 
self). I mean it is still entirely un- 
American, and therein lies its greatest 
charm. One does not travel ten thou- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



177 



sand miles to find a poor duplicate of 
St. Paul or Denver. The nurses' quar- 
ters are delightfully spacious, the at- 
mosphere of the house friendly, refined, 
hospitable, and up to this present writ- 
ing I can see no reason why we should 
not be both comfortable and happy." 

Christmas letters have been received 
by several from the Misses Mary Cordes 
Barker, Isabelle Bamber and Mary J. 
McKelvey, ex-army nurses on duty in 
Panama, who seem to be enjoying their 
work on the Isthmus. The Misses Call 
and WoUpert are in Mexico, the latter 
in the southern part, where the weather 
is intensly hot, "far hotter than the P. I." 
Ex-Chief Nurse Mrs. Bauer and Miss 
Mary J. Kennedy are at Mazattan, Mex- 
ico. They are the only nurses in a hos- 
pital consisting of five tents. These 
nurses are five days by boat from Guy- 
mas, where Miss Catherine Edwards has 
charge of a hospital. 

The deep sympathy of her sister nurses 
and friends is extended to Miss Henri- 
etta McRae, who has recently been be- 
reaved by the death of her sister under 
peculiarly sad circumstances. We hear 
that Miss McRae will devote her life to 
the little motherless family. It would 
be hard to imagine more wise, tender 
care than she will give them. 

All friends of the Army Nurse Corps 
should know the "Princessa," because 
she is one of their "second generation" — 
the baby daughter of a most popular ex- 
chief nurse. Her mother writes an in- 
teresting description of the Princessa's 
Christmas, which is delightful enoiigh to 
reproduce for the benefit of our nurse 



corps at large: "Santa Claus was most 
generous to her. Four beautiful sou- 
venir spoons were added to her collec- 
tio'n (she already has twenty-two). 
Teddy Bear got a little brother and a 
'B'rer Rabbit' to keep him company. I 
dressed a beautiful stockinet doll from 
'Best's' and filled a tiny trunk withj 
changes of raiment; Mollie Layton 
Crozier (ex-army nurse) dressed a boy 
and girl doll for her; Mrs. Krauskopf 
Allyn (ex-army nurse) sent an embroid- 
ered cap ; the Misses Gertsch and Mc- 
Evoy (ex-army nurses) sent a big bunch 

of real violets ; Mrs. sent two little 

Dutch linen dresses and three dolls. 
There were horns and balls, automatic 
toys, carts, baskets, tin pails, and even 
a tiny bottle of wine to drink to her 
'good health.' She was the dearest thing 
in her little pink gown, her long, heavy 
hair in fluffy rings all over her head. She 
was not at all afraid of Santa Claus 
when he came dashing in, with his pack 
on his back and the calesin full of things. 
'B. P.' was Santa, and looked the part 
in a costume which I made. The old 
calesin was fixed up in turkey red and 
cotton (for snow). There were bells 
and bows all over the harness and Santa 
'sure' came with a dash, for he was driv- 
ing my Australian horse, who walks on 
two legs and paws the air with the other 
two. All this was at the house of a 
friend. The next day the Princessa had 
her own tree (a real one from Baguio). 
The day after was, in very truth, a 'day 
after.' The Princessa (who will not eat 
candy) was the only one who was not 
the worse for the two Christmases." 



CliitoriaUp ^peafeing 



The Visiting Committee's Report 

The New York City Visiting Commit- 
tee of the State Charities' Aid Associa- 
tion, which has been investigating the 
three years' course of the training schools 
for nurses, has presented its report to the 
Department of Public Charities. 

One of our contemporary nursing 
journals, in commenting on this report 
editorially, makes some assertions which 
we think are ill advised and certainly pre- 
mature. It says: "We believe that this 
report practically brings an end to the 
discussion as to the wisdom and justice 
of the three years' course. Political or 
commercial interests may retard its uni- 
versal adoption, but we feel that the 
standard has been fixed, and the large 
schools which do not adopt it will be rec- 
ognized as belonging to a lower grade." 

With all due respect to the belief and 
feelings of our contemporary, the above 
statements are very far from fact, for 
instead of settling the vexed question, 
those who have an intelligent knowledge 
of the nursing situation will find little 
that is convincing in the report. 

We shall not attempt to review the re- 
port, for this is most thoroughly and 
ably done by Miss Charlotte Aikens, 
whose article appears in this number, but 
we will consider the value of the weight 
of evidence given. In discussing the 
question of the three years' course in his 
article, which also appears in this num- 
ber, Dr. Hugh Cabot states that before 
accepting opinions as conclusive we must 
first decide what classes of people are 
entitled to opinions worthy of considera- 



tion and what relative value these opin- 
ions should have. In judging the quali- 
fications of the three years' course Dr. 
Cabot believes those entitled to opinions 
are the nurses themselves and the phy- 
sicians. In speaking of those profes- 
sionally interested in the teaching of 
nurses he says: 

"The majority of the published opinions 
are those of superintendents of nurses, or 
at least those professionally interested in 
the teaching of nursing. Deeply as we 
must respect their opinions, it may fairly 
be doubted whether they are in as sound 
a position to judge of their finished prod- 
uct as those who have a less personal in- 
terest." 

From this point of view the report 
loses much of its value, for it states: 
"Of the one hundred and forty-two re- 
plies received that were definite and per- 
tinent, sixty-six were from superinten- 
dents of training schools, or of nurses, 
and seventy-six from superintendents of 
both hospitals and training schools, or of 
hospitals alone." The report further 
states: "As far as the care of the sick 
in their own homes by trained nurses 
after graduation is concerned, it is to be 
remembered that those replying speak 
from the experience of institutional 
rather than of private nursing. As to the 
weight that should be given these re- 
plies in considering the question of how 
desirable or necessary a three years' 
course of training is to prepare a nurse 
to care for patients in their own homes, 
under the instructions of the physicians 
in charge, we express no opinion, etc." 



THE TRAINED NURSE AND HOSPITAL REVIEW 



179 



* * * "To be trained for private nurs- 
ing is the object of a large part of the 
applicants and, therefore, the better and 
more attractive such training is, the bet- 
ter will be the general character of the 
applicants." With the acknowledgment 
of the committee that a large part of 
applicants are trained for private nurs- 
ing, we naturally look to see how much 
voice the rank and file of private nurses 
have had in the committee's report, and 
we find that the only representation is a 
semi-official resolution of the Nurses' 
Associated Alumnae — a resolution pro- 
posed on a pleasure trip, just before the 
boat arrived at its objective point. 

It may be of interest here to quote one 
or two views on the value of the opin- 
ions of nurses' organizations. Dr. Cabot 
says: "The great body of graduate 
nurses is, I believe, a thoroughly safe 
tribunal, but it has never as yet been pos- 
sible to obtain its unbiassed opinion. 
The alumnae societies and state associa- 
tions have, in a great majority of cases, 
voiced the sentiment not of the large 
body of nurses but of a small number of 
executive officers, a large proportion of 
whom are superintendents of nurses, 
superintendents of hospitals, or at least 
not practising nurses." 

Miss *Aikens says : "Regarding the 
'weight' which should be given to the 
resolutions of the Nurses' Associated 
Alumnae in favor of the three years' 
course, it will be admitted that much de- 
pends on who is doing the weighing. 
There are wheels within wheels in nurs- 
ing, as in all other lines of work. Some 
of these wheels are not plainly visible, 
and the committee is not to be blamed 
for not noticing them, but the wheels are 
there nevertheless." And again : "The 
thing we object to is the impression given 
that this hastily considered resolution. 



proposed on the deck of a steamer while 
en route to the Jamestown Exposition, 
should weigh particularly in deciding 
such a question." 

We admit that the statement that the 
resolution represents the opinion of rep- 
resentative women of the whole country, 
from the Atlantic to the Pacific, sounds 
very imposing, and would undoubtedly 
carry much weight with the uninitiated. 
But when we know that it is the expres- 
sion of delegates, instructed and unin-' 
structed, absolutely ruled and governed 
by a few women, who want the three 
years course and are determined to have 
it, the matter takes on a different aspect, 
and little weight could be attached to the 
resolution. 

It will be seen, therefore, that in the 
Visiting Committee's Report practically 
only one portion of those entitled to opin- 
ions worthy of consideration have any 
representation, namely, those profession- 
ally interested in the teaching of nursing, 
the physicians who see the nurse at work 
in private homes, the public who employs 
the nurse and the nurses themselves be- 
ing almost overlooked. In our opinion a 
report on this question overlooking these 
important factors could hardly be con- 
sidered as carrying great weight. 



As we go to press we are in receipt 
of the following letter from a head 
nurse of prominence, which is so apropos 
of the matter under discussion that we 
publish it in this department: 

Dear Editor — I enjoy immensely the 
articles, "Extracts from a Pupil Nurse's 
Diary." They are like T. R.'s "Big 
Stick" — they inspire and encourage' 
others to "speak up." 

Miss Addams's statements were not 
overdrawn from the patient's standpoint, 
although they probably were from the 
standpoint of the superintendent or the 
head nurse, who are too busy with the 



180 



THE TRAINED NURSE AND HOSPITAL REVIEW 



"business" of nursing to know about the 
little details which are so important to 
the patient. 

Training schools are gradually drift- 
ing into a sort of "red-tape" contest, and 
are judged, in the profession, according 
to their method of winding the tape. 

After thirteen years of nursing, insti- 
tutional and otherwise, I am of the 
opfnion that the only way to find out 
what kind of training our nurses are 
receiving is by practical experience as 
an ordinary seven-doUar-a-week patient, 
and I would suggest that those who are 
discussing this question take the "rest 
cure" (?) incognito occasionally in a 
hospital ward. It is the "up-to-date" 
method of inspection. Who is brave 
enough to do it? 

A Head Nurse. 

This suggestion in regard to the "rest 
cure" might be a vaUiable one to pass 
on to the next committee that under- 
takes to investigate our training schools 
and their methods. 

+ 
We Want Your Opinion 

There are several reasons why this 
magazine has continued to hold its lead 
in .spite of the increased competition that 
comes with each year. One is that 
though vitally interested, yet we are 
merely onlookers at the course of events, 
and our position as a detached yet watch- 
ful spectator gives us a certain advan- 
tage in determining the right perspective 
and relative value of incidents which 
mark the progress of nursing affairs. 
Another reason is that we do not force 
our own opinions upon our readers, nor 
dictate to them. We know that nurses 
recognize the value of an exchange of 
ideas, and that in order to be at all times 
the vigorous exponent and defender of 
the best nurse and nursing "it behooves 
the nurse to get many another viewpoint 
than her own." Still another reason is 



that we try to give the nursing profession 
what it wants. 

It has recently been suggested to us 
that the usefulness of The Trained 
Nurse woukl be greatly increased if we 
would publish less of the unimportant 
news of alumuK associations and gradu- 
ating exercises, etc., and devote the space 
thus saved to publishing a larger number 
of practical articles. 

Of course it is not meant that we 
should give up news altogether. It was 
suggested that we should continue to 
print the reports of national societies and 
any important event, but it was pointed 
out that a nurse in one State was not 
interested to learn of the graduating ex- 
ercises of some hospital training school in 
a State a thousand miles away. 

Yet. on the other hand, from time to 
time we have had numerous compli- 
ments on our news department, and 
many nurses are delighted to read just 
such news items as those referred to. 

We cannot please all our subscribers 
all the time, but there is no good reason 
why we should not please the majority 
of our subscribers most of the time. 
Therefore, we want your opinion. Writ? 
to us and let us know, shall we continue 
The Trained Nurse exactly as it is to- 
day, or shall we cut down the Nursing 
World to perhaps three or four pages of 
important news and devote the five or six 
pages thus gained to practical articles? 
Please send us a postal card expressing 
your wishes. 

+ 
Notice 
Those wishing to read the editorials 
from which Dr. Cabot quotes in his 
article in this issue, entitled "Is the 
Three Years' Course Unnecessarily 
Long?" will find them in the July. 1907, 
and November, 1907, issues of The 
Trained Nurse. " 



In tlje Jturstng l^orltr 

ARTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATURE OR NOT, ARE CONTRIBUTED, AND 
DO NOT NECESSARILY REPRESENT THE IDEAS OR POLICY OF THIS MAGAZINE. 



Graduate Nurses' Association of Conn. 

The Graduate Nurses' Association of Con- 
necticut, held its regular meeting at the Hotel 
Green, Danbury, Conn., on Wednesday, Feb- 
ruary 5, 1908, Miss R. Inde Albaugh, of 
Grace Hospital, New Haven, presiding. Dr. 
Bailey opened the meeting with prayer and an 
address of welcome to the Association. 

The routine business was quickly disposed 
of and the subject matter of the meeting, 
district and visiting nursing, was most ad- 
mirably handled by Miss Van Cleft, district 
nurse for the country district around Lake- 
villc, Conn., and Miss Wilkinson, district 
nurse of Hartford. Miss Van Cleft, formerly 
of the Henry Street Settlement, New York, 
contrasted the work of the visiting nurse in 
the city and in the country, giving a bright, 
interesting word picture of what a day's work 
in each place might be. 

Miss Wilkinson gave some statistics con- 
cerning Dj^strict Nursing in Connecticut, de- 
scribing the origin and development of the 
present management of various societies, and 
the nature and scope of the field of work in 
Hartford. Bright stories of her own and her 
assistants' experiences added to the interest 
and enjoyment of her talk. 

A question box, with open discussion, fol- 
lowed. This feature is proving to be an in- 
teresting and valuable one in the meetings. 

The arrangements for the meeting wore in 
charge of Miss Gallagher, local councilor of 
the State Association, and were most excel- 
lently carried out. The splendid equipment 
and service of the new Hotel Green were at 
the disposal of the .Association and were 
greatly appreciated. 

A formal vote of thanks was tiiuk-red Dr. 
Bailey and the Danbury nurses for their hos- 
pitality. 

The annual meeting will be hold in P.ridgo- 
port, Wednesday, May 6, 1908. 



Louisiana State Nurses' Association. 

The Louisiana State Nurses' Association 
held its fourth annual meeting February 22, 
at 3 P. M., at the New Orleans College of 
Dentistry. 

+ 
Buffalo, N. Y. . 

The regular monthly meeting of the Buffalo 
Nurses' Association was held Monday, Feb- 
ruary 3, at 3 o'clock, at the Women's Union. 
Mrs. William W. Armstrong, of Rochester, 
was present and spoke on "Probation Work 
Among Women." Mrs. Armstrong's address 
was most interesting and instructive and was 
listened to with marked attention by all 
present. Many Buffalo club women were 
guests of the association. 

The musical programme was in charge of 
Mrs. Clara Thorns. Miss Florence Reid sang 
several selections, among them being a lullaby, 
the words of which were composed by Mrs. 
Henry Altman and the music by Mrs. Clara 
Thorns. 

Miss Nellie Davis, superintendent of t!io 
Erie County Hospital, presided in the absence 
of the president, Mrs. Harriet Storck. 

Miss Virginia Rau was elected to member- 
ship and the name of Mrs. Henry Altman 
was proposed for honorary memborsliip in 
recognition of her work in establishing medi- 
cal inspection in tiie public schools of Buffal(x 

Preceding the meeting a luncheon was given 
at tile Vincent Tea Rooms by the Executive 
Board in honor of Mrs. .Armstrong. Other 
guests were Mrs. Henry Altman, Mrs. Frank 
Bliss and Mrs. Clara Thoms. 

A half-liour reception followed the mooting, 
when all were given an ojiportunity to meet 
Mrs. Armstrong. 

Refreshments were served by the social 
committee, Mrs. Jennie T. Anderson, Miss 
.Antoinette WoJjcr, Mrs. John L. Brodio, Miss 
Marie Coleman and Miss Helen Collins. 



182 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Buflfalo is to have medical inspection of its 
public schools. 

Two years ago, at the request of the Nurses' 
Association, the City Federation of Women's 
Clubs undertook the work and made Mrs. 
Henry Altman, chairman. 

Mrs. Altman has been indefatigable in her 
eflforts, and it is due to her that the appropria- 
tion for the work has been made. Other 
members of this committee were : Mrs. 
Frank Shuler, president of the Western Fed- 
eration of Women's Clubs; Mrs. Edgar C 
Neal, Mrs. William Justice, Dr. Jane Carroll 
and Miss Sylveen V. Nye. 

The appropriation is for $2,500, $1,000 each 
for two physicians and $600 for one nurse. 

The work will probably begin in September 
and more physicians and nurses will be added 
later on. 

Civil service examinations will soon be held 
for applicants. 

Mrs. Harriet Dorr Storck, president of the 
Buffalo Nurses* Association, and Dr. Maud J. 
Frye, an honorary member of the association, 
have returned from a two months' trip, which 
included Washington, Baltimore, Philadelphia 
and Atlantic City. 

The many friends of Miss Elizabeth Owen 
sympathize with her in the death of her sister. 
Miss Owen is the chairman of the financial 
committee of the association. 

Miss Adelaide Marsden attended the mid- 
winter meeting of the Western Federation of 
Women's Clubs, at Lockport. 

Miss Edna Abbey, a graduate of Dr. Lee's 
private hospital, of Rochester, has located in 
Buffalo. 

Miss Laura Flavin, a graduate of Mcrcj 
Hospital, of Buflfalo, has recovered from a 
long and severe illness and has resumed her 
work. 

Miss Margaret Kamerer, of Buflfalo, is 
spending the winter in Chicora, Penn. 

Miss Maude Caldwell, of Buflfalo, has ac- 
cepted a position in the Brooks Memorial Hos- 
pital, at Dunkirk, N. Y. 

Mrs. Margaret Dreger, of the Buflfalo Gen- 
eral Hospital, was recently engaged to accom- 
pany a patient who was to be deported to Aus- 
tria. Mrs. Dreger was in readiness to start 
the following morning when the patient es- 
caped and has not yet been found. 

Miss Helen Dawson is spending the winter 
in Seattle, Wash., with Dr. Mary Huntley and 
Miss Rachel Knott. 



Miss Marie Rausch, a graduate of the Sis- 
ters of Charity Hospital, has gone to Okla- 
homa City to reside. 

The annual banquet which was announced 
in the calendars to be held in March, has been 
postponed to some time in April m deference 
to the members who observe Lent. 

Buflfalo now has fourteen training schools 
for nurses. 

The March meeting of the association will 
be devoted to a discussion of ways and means 
for raising money for the "Club House Fund." 

+ 
New York City. 

The regular meeting of the Association of 
Graduate Nurses of Manhattan and Bronx 
was held at the Polyclinic Hospital, Monday 
afternoon, February 10, 4:30 o'clock. 



The regular monthly meeting bf the Alumnae 
Association of the New York City Training 
School for Nurses was held, as usual, on the 
second Tuesday, February 11, at the Academy 
of Medicine, West Forty-third street. The 
meeting was called to order by the president, 
Miss Pindell, and the minutes of the last meet- 
ing were read and approved. Miss Yocom 
and Miss Grace Forman gave a most interest- 
ing and encouraging report of the new reg- 
istry. Other n^atters of business being attend- 
ed to. Dr. Stowcll was introduced and talked 
in an entertaining manner on the ways and 
means of broadening the nurses' outlook. Af- 
ter the lecture, as usual, an adjournment 
was made to the banquet hall, where Miss 
Grace Forman presided over a prettily ar- 
ranged St. Valentine's Tea. 

Florence M. Kelly, R. N. 
Corresponding Secretary. 

+ 
Camp Roosevelt. 

On the afternoon of Wednesday, February 
5, the regular monthly meeting of Camp 
Roosevelt was held at the home of Miss 
Edith Abrams, 115 West One Hundred and 
Twenty-seventh street. Mrs. Gaylor presided. 
The amendment proposed at the last annual 
m«:( ting of the Spanish-American War Nurses 
to Article i. Section i, of the by-laws, adopted 
igoT, and amended 1905, was again freely dis 
cussed and unanimously voted on to be again 
presented at the next annual meeting. After 
aU business on hand had been finished up an 



THE TRAINED NURSg AND HOSPITAL REVIEW 



183 



adjournment was made and we were enter- 
tained with some delightful music and an elab- 
orate "tea" presided over by Mrs. Abrams, one 
of the sweetest and prettiest of "mothers" we 
know. The next meeting of Camp Roosevelt 
will be held on Monday, March 2, 2 130 to 5 
p. m., at Miss Charlton's, 596 Lexington ave- 
nue, and as this will be the annual meeting of 
the camp a large attendance is looked for. 
Florence M. Kelly, R. N., 
420 West One Hundred and Sixteenth street. 

+ 
Blackwell's Island. 

We present a drawing of the new Home for 
Nurses, now nearing completion, at the 
Metropolitan Hospital, Blackwell's Island, N. 
Y. This island is part of New York City, is 
situated in East River and reached by a ferry 
which takes about three minutes to cross the 



The new nurses' home, which is nearing 
completion, is located on one of the finest 
sites in New York City, and will give single 
rooms to all nurses, with spacious entrance 
hall, library and sitting rooms. The school is 
registered and offers a three years' course of 
training, giving an allowance of $10 per 
month the first year, $12 the second and $15 
the third year. Applicants must be between 
twenty-one and thirty-five years of age and 
have one year in high school, or its equivalent. 
Classes formed every two months. 

Agnes S. Ward, Superintendent. 

+ 
Brooklyn, N. Y. 

At the annual meeting of the Brooklyn Hos- 
pital Training School Alumnae, held February 
4, the following offices were elected for the 
following year: President, Mrs. Kelly; first 




river. The island is about three miles long 
and one-sixth of a mile wide. 

In 1651 it was granted to a Dutch officer, 
Captain Francis Fyn. In 1665 it was con- 
fiscated by the British, and in 1668 was 
granted to Captain John Manning, then in 
command of the fort situated at the Battery. 
Robert Blackwell married the step-daughter 
of Captain Manning. The island from that 
time was called after the Blackwell family, 
who held it until 1828, when it was sold to the 
City of New York. 

It would be difficult to find a more ideal 
location for a hospital, surrounded as it is by 
water, with spacious grounds and beautiful 
trees. 1 he Metropolitan Hospital, with a ca- 
pacity of over 1,300 beds, is located at the 
north end of the island, and plans are at 
present under way to add buildings to ac- 
commodate 2,000 more patients. 



vice-president. Miss Buchanan, R. N. ; second 
vice-president. Miss Finneran, R. N. ; record- 
ing secretary, Mrs. de Zouche, R. N., re- 
elected; corresponding secretary. Miss Kerr, 
R. N. ; treasurer. Miss Holt, R. N., re-elected; 
director. Miss Rothermund, R. N. 
+ 
Alumnae Bazaar, Boston, Mass. 
The bazaar held in Parish Hall, Trinity 
Church, Boston, in December, by the Alumnae 
Association of the Massachusetts General 
Hospital Training School for Nurses, to se- 
cure funds to endow a bed for sick nurses, 
was a most gratifying success. Rev. Dr. Mann 
kindly gave us the use of the hall, and the 
Associates of the Guild of St. Barnabas fur- 
nished the entertainment, which included per- 
formances of the Italian marionettes, music 
by the entertainment committee of the Sewing 
Circle League, and the Highland Club Or- 



184 



THE TRAINED NURSE AND HOSPITAL REVIEW 



chestra of West Roxbury, and demonstrations 
of bed-making, etc. Many class reunions took 
place in the tea-rooms during the two days of 
the sale, and happy occasions they were. Fol- 
lowing are the names of those who had charge 
of the tables and the amounts they made : 
Fancy work, Miss Annie C. Carlisle. . $956.50 

Bag, Miss Lilian H. Morris 320.61 

Doll, Mrs. H. L. Burrell 242.70 

Candy, Miss Ada McNab 225.76 

Flowers, Mrs. G. A. Craigcn 255.73 

Household, Miss Annie C. Carstensen 204.00 

Cake, Miss Rachel Bourke 119.02 

Infants, Miss Bessie Fullerton 121.50 

Tea-room, Miss Emma A. Anderson. 11 1.55 
Advertisements, Miss Emma A. An- 
derson 160.00 

Entertainment, Miss Mary Sargent... 92.01 

Palmists 60.75 

Admission tickets 80.45 

Other receipts 357-56 

Total $3,308.14 

Disbursements 383.03 

Balance $2,925.11 

This amount added to the $861.48 already 
subscribed by the nurses themselves, makes 
$3,786.59, which is very near the sum of $5,000 
for whicli wc are working. 

Annie H. Smith. 
Business Manager for the Committee on Free 
Bed Fund. 

+ 
Fall River, Mast. 
The regular meeting of the Nurses' Alumnae 
Association was held February 5, 1908. 

The meeting was well attended and the reg- 
ular business transacted. 

Or George L. Richards gave a very inter- 
esting, informal talk on his recent trip to 
Europe, and spoke at some length of the hos- 
pitals he had visited. 

I.ighr refreshments and a social half-hour 
followed. Laura W. Wood, 

Corresponding Secretary. 
+ 
Paterson, N. J. 
The regular meeting of the Alumnae Asso- 
ciation of the Training School for Nurses of 
the Paterson General Hospital was held on 
February 4, 1908. There was a large attend- 
ance. 

Mrs. Jeanette Peterson, of Pasadena, Cal., 



was appointed as delegate to the Associated 
Alumnae convention in San Francisco. 

Refreshments were served after the meeting 
adjourned. 

+ 
Philadelphia, Pa. 

The graduation exercises of the Training 
School for Nurses of St. Mary's Hospital of 
Philadelphia took place on Tuesday, January 
14, 1908, in the lecture hall of the hospital. 
The same was beautifully decorated with 
palms and flowers, the class colors of gold 
and blue prevailing everywhere. 

Addresses were made by Dr. J. O. Kelly. 
medical director of the hospital, and Dr. Will- 
iam Zentmeyer, a member of the staff. The 
opening address was made by Dr. M. Howard 
Fussel, member of the staff. 

The young graduates were honored witii tho 
presence of many members of the Alumnae 
Association as well as their friends. The 
diplomas were presented by the Reverend 
Mother Mary Immaculate, the provincial of 
the Order of St. Francis, who conduct tin- 
iiospital. 

The graduation pins were presented to th'.- 
young graduates by Miss Frances J. Lundy 
the head nurse of the institution since the 
foundation of the training school. 

Miss Helen Lynn delivered the farewell ad- 
dress; Miss Emma DeCray acted as class his- 
torian ; and the graduation address was made 
by Dr. A. G. Downs, a member of the staff, 
who in imposing words laid before the young 
graduates the duties of their vocation, true tf> 
the motto: "Semper Fidelis." 

Graduates — Emma DeCray, Dorothy 
Schaffer, Delia Anderson, Nellie Dugan, 
Mary O'Brien, Helen Lynn. 

A banquet and dance followed the rcccptioii. 



The regular stated meeting of tlie Xurses' 
Alumnae Association of the Medico-Chirurgicai 
Hospital was held on Wednesday, February 5. 
at the hospital, and was well attended. 

The secretary is still receiving money from 
the sale of the tickets for the dance held in 
December, and reports a neat sum realized to 
be used for the endowment fund. 

A vote of thanks has been tendered to the 
Misses E. B. Lobb and Gertrude Gerhard and 
Afrs. B. F. Schloss for their kindness in regard 
to the Nurses' Dance. 

Three new applicants, the Misses Cadden, 



THE TRAINED NURSE AND HOSPITAL REVIEW 



185 



Anwyl and Dctwilcr, have been received as 
members of the association. 

After all the regular routine of business, tea 
was served and a pleasant time enjoyed by all 
present. Mr.s. Phaon J. Rex. 

+ 
Kane, Pa. 

A business meeting of tiie Alumnae of the 
Kane Summit Hospital was held Tuesday 
afternoon, January 28, at the hospital. 

On account of the large number of mem- 
bers out of town on professional work, only 
a small numl^er were present. 



May Parsons, of Kushequa, class of 1907, who 
became the wife of Mr. Joseph Robson, of 
Niagara, where they have now taken up their 
residence. Miss Jessie Crawford, also of 
Kushequa and class of 1907, and Mr. Fred 
Ormundson, of the same place, had a quiet 
home wedding Sunday, January 19. Rev. Mr. 
Lusher officiated at the two last named wed- 
dings. 

These nurses were destined to become stars 
in their profession, but instead they chose to 
shine in a different sphere. We wish them 
all godspeed. 




IWCK VIEW OF NIRSHS" IIO.AH0 IX MA.MI.A. 
Solcdad iiiid Miss Hansen In the boat. Soo ''Iteniinisfonces of an Army Nurse. 



Mrs. Anna Stoll occupied the chair. A fair 
amount of business was disposed of, after 
which light refreshments were served by Dr. 
Mary Hayes, superintendent of the training 
school. Social chat was indulged in for some 
time, after which the meeting was formally 
adjourned. 

The marriages of our graduates still con- 
tinue. On November 25 Miss Jessie Rooney, 
class of 1906, became the wife of .Mr. Max 
Schuch. Rev. Father Curley, of tlic Catholic 
Church, performed the ceremony. Wednes- 
day, December 25, was the bridal day of Miss 



Cincinnati, O. 

The graduating exercises of the class of 
1908 of the Cincinnati Hospital Training 
School for Nurses were held in the amphi- 
theatre of the hospital on the evening of Jan- 
uary 14, 1908. 

The exercises consisted of addresses by 
members of the hospital staff and officers of 
the city administration. The audience was 
very large and appreciative badges and diplo- 
mas were presented to fifteen graduates. 

A reception followed in the hospital library 
for the nurses and their friends. The fol- 



186 



THE TRAINED NURSE AND HOSPITAL REVIEW 



lowing evening, January 15, 1908, the fifteenth 
annual meeting of the Nurses' Alumnae Asso- 
ciation was held at the nurses' home, and offi- 
cers for the following year were elected. 

Also the first steps were taken to create an 
endowment fund, providing a permanent bed 
for sick graduates of this school, each nurse 
being assessed the required amount. A com- 
mittee was appointed with full power to act, 
and a much desired object is being finally 
achieved. The evening closed with a banquet 
in the dining room of the Cincinnati Hospital. 

+ 
Brainerd, Minn. 

The graduating exercises of the Northern 
Pacific Hospital Training School for Nurses 
were held January 7, 1908. 

The exercises of the evening were presided 
over by W. H. Gemmell, general manager of 
the Minnesota and International Railroad, 
who opened with a few well chosen remarks. 

Rev. J. R. Altcn, chaplain of the hospital, 
invoked the blessing of God on the exercises. 

The annual report of the school was read 
by the superintendent. Miss Laura Whittaker. 
It told of the establishment of the school and 
the good work it had accomplished. Among 
other things Miss Whittaker said: 

While we do not undervalue the importance 
of proper training, the more we have to do 
with training school work the more we realize 
that the best kind of training will never make 
a nurse, but only aid in her development; the 
distinctive qualities must be born in her. 

Nurses are always under great obligations 
to the medical profession for counsel, instruc- 
tion, and also for work. On the other hand, 
nurses are very necessary to doctors in the 
scientific care of the sick. 
They may live Tvithout poetry, tnusic and art, 
They may live without fame, just at the start. 
But to make a success, and to fill up their 

purses 
Medical doctors cannot live without nurses. 

Dr. J. A. Quinn, of St. Paul, delivered the 
address to the graduating class. The address 
was replete with good thoughts, being largely 
along the lines of the work of the nurses, 
dwelling on the duties and requisites of the 
nurses. 

He paid the following tribute to the super- 
intendent: "I congratulate you in having the 
opportunity to have been taught by Miss 



Whittaker, than whom no superintendent of a 
training school for nurses in any hospital in 
this country is better, and very few equal, 
either in scientific knowledge, teaching ability 
or attributes of womanly character. The suc- 
ceiss of her work is recognized and known to 
all connected with hospitals." 

Rev. Father O'Mahoney delivered an ad- 
dress, in which he paid tribute to the work of 
the nurse. 

The musical programme had been arranged 
especially for the class, which represents four 
nationalities, American, Canadian, Irish and 
Scotch. 

The graduates are Margaret Louise Buchan- 
an, Susan Vivian Miles, Mary Agnes Gaven 
and Elinor Elizabeth Rose. 

+ 
Colorado Springs. 
The usual monthly meeting of the Colorado 
Springs Nurses' Registry Association was held 
in Grace Church Parish House on February 
5. Miss L. L. Hudson was elected unani- 
mously to succeed herself on the State Board 
of Nurse Examiners as representative from 
Colorado Springs and her name sent to the 
Governor for his favorable consideration. 

+ 
Poughkeepsie, N. Y. 
The annual business meeting of the Alum- 
nae Asociation of Vassar Brothers' Hospital 
Training School for Nurses was held at 24% 
Academy street, on February 4, 1908. After 
roll call the minutes of the last meeting were 
read and approved, followed by the reports 
from the officers present. The election of 
officers was as follows : President, Miss Emily 
K. Shaw; vice-president. Miss Claribel Wheel- 
er; treasurer. Miss Grace Palen; recording 
secretary. Miss J. Maude Rood; corresponding 
secretary. Miss Mary B. Ebert. Six new di- 
rectors were appointed to take the place of the 
retiring six. Corresponding Secretary. 

+ 
Troy, N. Y. 

The regular monthly meeting of the Alumnae 
Association of the Troy City Hospital was 
h'^ld at that institution on February 3. The 
business of the meeting was to elect officers for 
the ensuing year. In the absence of the presi- 
dent the vice-president, Miss Graham, pre- 
sided. The result of the ballot follows: 

Directress, Sister Annie; president. Miss 



THE TRAINED NURSE AND HOSPITAL REVIEW 



187 



Julia M. Littlefield, R. N. ; vice-president, Miss 
Frances A. Galvin, R. N.; secretary, Miss 
Elizabeth C. Doyle, R. N. ; treasurer. Miss 
Cecelia M. Toner, R. N. A vote of thanks 
was tendered the retiring officers for their ex- 
cellent work during the past year. 

Elizabeth C. Doyle, R. N. 



Personal. 

The vacancy for General Superintendent of 
Training Schools at the Kings County Hospi- 
tal, caused by the resignation of Miss Martha 
O'Neill, has been filled by the appointment of 
Miss Isabel Burrows of the Cumberland 
Street Hospital, Brooklyn. 

Miss Burrows is a graduate of the Kings 
County Training School, and has been super- 
intendent of the Cumberland Street Hospital 
Training School since the opening of that in- 
stitution in 1902. 

Handicapped by the inconveniences of an 
"infant" institution, Miss Burrows organized 
her school with a nucleus of seven or eight 
pupil nurses, and it was due only to her in- 
domitable courage and perseverance that the 
present high standard of the school has been 
attained. With a grit and determination such 
as few women possess the mountains that rose 
in her path were made level and the clouds 
on the horizon of the future of the school 
turned slowly around and showed the silver 
lining. The difficult exigencies and trials of 
those earlier days are looked back upon now 
with triumph as they lie conquered, and the 
Cumberland Street Training School can raise 
its flag as second to none in Greater New 
York. 

During her stay in Cumberland Street Miss 
Burrows has inaugurated many improvements. 
Everything conducive to the welfare and 
comfort of patients and nurses was at once 
sought after, and adopted, if practicable. Miss 
Burrows was instrumental in having the hos- 
pital registered under the State Board of Re- 
gents, in order that her graduates might be 
eligible for the certificate of "R. N." A 
course of lectures on massage by a profes- 
sional masseuse is another feature of her fore- 
sight and zeal. 

Having endeared herself thus to ner nurses 
— graduates and pupils — it was with feelings 
of mingled satisfaction and regret that the 
announcement of her appointment to a more 
extended field of duty was received. 



Besides the large school attached to the 
Kings County Hospital, Miss Burrows will as- 
sume control of the nursing organization of 
Cumberland Street Hospital, Bradford Street 
Hospital and Coney Island Hospital, all of 
which come under the general administra- 
tion of the Kings County Hospital. 

Her pleasing personality and great execu- 
tive ability make the success of Miss Bur- 
rows's administration doubly sure. 

It was a wise head that selected this capable 
young woman for so responsible a position 
and the authorities are to be congratulated on 
the choice they have made. 

While she takes with her the congratula- 
tions and good wishes of her school and 
friends, she will also take the regret of those 
whom she leaves behind, but there is some 
consolation in knowing that she will watch 
over them still like the proverbial "good 
angel." 

A farewell reception was tendered to Miss 
Burrows on the night of January 13, at which 
the Training School Alumnae, the Medical 
Board and staff of the hospital expressed 
their appreciation of Miss Burrows's services 
to the institution. 

ur. Orlando Ritch, on behalf of the Medical 
Board, presented to Miss Burrows an artis- 
tically engrossed testimonial. 

Dr. Bacon, superintendent of the hospital, 
gave his employes carte blanche, and the small 
hours of the morning found many still en- 
joying themselves. C. B. 



Miss Margaret A. MacBride, of Montreal, 
Canada, a graduate of the Mary Fletcher Hos- 
pital, Berlin, Vt., and member of the Cana- 
dian Nurses' Association, and Miss Kathleen 
E. Steacy, of Montreal, Canada, are at the 
present time taking a course in the Swedish 
system of massage, medical and corrective 
gymnastics, at the Pennsylvania Orthopedic 
Institute and School of Mechano-Therapy, 
Inc., Philadelphia, Pa. 



Miss Daisy Barclay, graduate of Mercy 
Hospital, Des Moines, Class '03, after an ex- 
tended visit with relatives in South Dakota, 
has returned to the city and resumed private 
nursing. 



Miss Margaret J. Newcomb of Brookville, 
Pa., graduate of the Woman's Hospital, Phil- 
adelphia, Pa., fell December 26, breaking Iicr 
ankle and injuring her foot very badly. 



188 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Births. 
Born, to Dr. and Mrs. J. B. :3herbon of the 
Victoria Sanitarium, Colfax Springs, Iowa, 
January 14, twin daughters, ^.irs. bherbon 
was formerly Miss Florence Brown, a gradu- 
ate nurse, and for some time connected with 
tlie State Hospital at Independence, Iowa. 

+ 
Marriages. 
Married, in St. Louis, October 10, 1907, Miss 
\V. M. Perkin, Spanish-American War nurse, 
graduate of St. Louis Training School for 
Nurses, to Mr. M. M. Garrett. At home, 
Thermopolis, Wyoming. 



Mr. and Mrs. Alfred Williams announce the 
marriage of their daughter, Nellie, to Mr. 
Lewis Frederic Heckman, Sunday, February 
9, at Cleveland, Ohio. Mrs. Heckman is a 
graduate of Aultman Hospital Training 
School, class of 1900. Mr. and Mrs. Heckman 
will make their home in Akron. 



Obituary. 

Miss M. M. Patcrson, a graduate of the 
Montreal General Hospital Training School 
for Nurses, died of typhoid fever at the 
American Hospital, Mexico City, Mexico, De- 
cember 30, 1907. Miss Paterson had done 
private nursing in Mexico City for the past 
five years, and was beloved by all who knew 
her. The nurses of Mexico, her friends and 
patients, have suffered a great loss. The re- 
mains were interred New Year's morning in 
the British Cemetery, Mexico City. 



It is with deep regfret that we announce the 
death of Miss Florence Hill, graduate of the 
German Hospital Training School, Brooklyn, 
New York, class of 1904. 

She died at her home, Brantford, Ontario, 
Canada, on November 23, 1907, after a long 
illness, borne with patience and fortitude and 
sustained by an unfaltering trust in Him who 
doeth all things well. 

Ala meeting of the Alumnae Association the 
following resolutions were adopted : 

Whereas Our dear classmate and co- 
worker has passed into the great beyond; be it 

Resolved, That the association has lost one 
of its most conscientious and faithful mem' 



bers, one whose life was an example of un- 
selfishness and love, a comfort to her class- 
mates and friends; be it further 

Resolved, That we extend our sincere sym- 
pathy and condolence to her mother and sis- 
ters in their great bereavement. 

Resolved, That a copy of these resolutions 
be sent to her family, placed on the minutes 
of the association and published in the mag- 
azines of nursing. 

Louise H. Muhlich, 
Della V. Knight, 
Mary D. Jenkins, 

Committee. 



The city of Stratford, Ont., was profoundly 
shocked at the sudden death of Miss Chilman. 
the much loved lady superintendent of the 
General Hospital, which occurred January 8, 
the result of a malignant form of la grippe. 

Miss Chilman had been for the past nine 
years lady superintendent of the hospital, in 
which position she had won the love and 
esteem of the community by her beautiful 
personal qualities, her kindness and skill and 
her ability in managing the affairs of the 
large institution. 

At a meeting of the Hospital Trust (the fol- 
lowing resolution was adopted : 

"The members of the City of Stratford 
General Hospital Trust are shocked at the 
serious 1 ss to the community occasioned by 
the sudden death of Miss Chilman, the lady 
superintendent of the institution, whose affair.^ 
she has advised and assisted them in admin- 
istering for many past years, iviiss Chilman 
possessed exceptional abilities, not only in the 
profession of nursing, but necessarily as a 
foremost executive officer. It is mainly to 
her that the public are indebted for the high 
character our institution has attained among 
the public hospitals of the province. She in- 
troduced many new features of value in prac- 
tice here and developed every branch of the 
service to the utmost degree of efficiency. 
She was wise and prudent in mind and man- 
ner, so that difficulties which constantly arise 
in dealing with interests diverse in their 
nature were always harmonized, and pleasant 
relations were constantly maintained between 
all who are concerned in hospital work." 



€1)0 CUitor'6 lettcr^bojc 



A Practical Way to Use "The Trained 
Nurse." 

To the Editor of The Trained Nurse: 

Among the great and constantly increasing 
number of periodicals that come into our 
houses, there are many which, when once 
read, may be given away or destroyed without 
a regret, since their contents, while interesting 
or timely, have no permanent value, vvnen, 
however, a magazine is composed chiefly of 
highly instructive articles, by specialists in the 
subjects of which they write, articles which 
give information later than the best text-books 
on the same topics, and which can be ob- 
tained in no other way, such a magazine is not 
lightly to be thrown aside. This is the case 
with The Trained Nurse, which brings., 
month by month to the women in the nursing 
profession news of the latest discoveries and 
methods in their world. The magazine is 
eagerly read upon its arrival, but many fine 
series of articles or single papers are worth 
referring to many times, as the nurse meets 
s'tuations in which they can be of practical 
help to her ; but this means a steadily growing 
pile of magazines, very often in quarters where 
every inch of room must be utilized to the best 
advantage. It also means a hunt through the 
accumulation of perhaps several years to find 
the half-remembered article that is desired. 
An index, under subject headings, in an alpha- 
betized book, is a valuable help, but the whole 
file must still be kept for reference. Having, 
however, hit upon a way in which to turn 
my magazines into a reference library which 
is a constant source of pleasure and help to 
me, it has occurred to me that other nurses 
may be glad to know of it. 

After reading each month's issue of The 
TxAiNED Nurse, I take it to pieces, removing 
the binding wires so that the leaves are not in- 
jured, and separate the articles of permanent 
interest from those which I shall not wish to 
rcler to again. These articles of permanent 
value arc placed together according to their 
subjects, and bound back in the magazine cov- 
ers, using for the purpose the brass manu- 



script binders which have two tongues that 
separate and turn down after passing through 
the back cover. On the front of each cover 
is written the subject of the articles contained 
within, and as new articles on that subject 
arrive they are added to the little volume, 
until the cover is full, when a new one is 
started. Of course, one may use covers as 
elaborate as she desires, but using the original 
covers saves time and trouble, and they will 
stand a good deal of service. 

The subjects in my collection are broad 
ones : "Fevers," "Pulmonary and Cardiac 
Diseases," "Mental and Nervous Diseases," 
"Diseases of Digestion and Elimination," 
"Surgery," "Obstetrics," "The Diet Kitchen," 
etc. Articles on such subjects as hydrother- 
apy, symptomatology, bacteriology and the like 
are gathered under the heading "Methods," 
and general advice to nurses, together with 
the stories of real life that one desires to keep 
on account of their human interest and the 
light they throw on the nurse's life, have the 
headmg "General Nursing and Experiences." 
Subjects occasionally overlap; an article may 
belong both in "Fevers" and "Contagious Dis- 
eases," for example, but classification is usually 
very easy. The most troublesome feature of 
this bock-making is that a leaf will sometimes 
have on one side the end of an article that be- 
lonj^s under one heading, and on the other the 
beginning of one quite different. In this case 
I copy the former, which is often only a para- 
gtaph or two, on a sheet of paper the same 
size as the pages. It only requires a few 
moments. The entire work to be done each 
month is the merest trifle, but when the collec- 
tion has had a little time to grow it forms a 
reference library of unique interest and value ; 
one that requires little space, that money can- 
not buy, and that helps to solve many a prob- 
lem for the nurse busy with practical work, 
yet anxious to keep up with the times, and to 
make use of every ray of light thrown on her 
path by those engaged in the same great fight 
v/ith the powers of disease and death. 

Minnie Genevieve Morse. 



190 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Influenza. 

To the Editor of The Trained Nurse: 

There is at present in this neighborhood a 
pronunced epidemic of influenza (I think in- 
fluenza a better name than "la grippe"), but 
with a low fatality. It is interesting, from the 
po nt of view of epidemiology, to ascertain if 
this be generally diffused. From the historical 
point of view it is a fact that a widespread 
mild influenza epidemic has nearly always, 
perhaps always, been the precursor of a more 
malignant epidemic of some form in the fol- 
lowing Fall. I do not connect them as cause 
and effect, but if the fact is universal they 
point to some common cause. 

Will you invite the profession to report their 
experience as to the prevalence of influenza? 
and communications thereon to the under- 
signed will be highly appreciated by, 
Yours very respectfully, 

M. R. Leverson, M. D., 
927 Grant Avenue, 
Bronx, New York. 

+ 
The Questions of Fee and Course. 
To the Editor of The Trained Nurse: 

I have been interested in reading the articles 
on the fee question. I feel sure until this 
matter is viewed in a just way the question of 
getting skilled nursing for the middle class 
wil' never be successfully arranged. The one 
hinges on the other, and until trained nurses 
will nurse this class for a moderate fee, those 
women, half-nurse and half-house help, will 
continue to be employed. Justly speaking, why 
should a clerk be charged as much as the head 
of the firm, who is able to pay twice as 
much and not feel it? Yet one is deserving 
of as much care as the other. I, for one, 
think that nurses should charge according to 
the circumstances of the patient. While in- 
mates of a home, nurses can fairly judge the 
financial standing of their patients and act ac- 
cordingly. I always charge patients what I 
think they can pay, and I have never yet found 
one of those "make believes." 

The question of the length of course of 
training is also a problem. I think that two 
y^ars is long enough to give a thorough train- 
ing in the essentials of nursing. I know 
from seventeen years experience in private 
duty and district work that part of my teach- 
ing is called constantly into practice, and part 
rarely so. I would not seem to dictate to 



those supposed to know more about the matter 
than myself. Yet I know one thing full well, 
that by the time a nurse puts in three years' 
hard work, at the end of the three years she 
comes out of the hospital to start on her own 
responsibility, in many cases almost broken 
down in health. There are exceptions, I ad- 
mit, but it takes exceptions to prove the rule. 
In my mental vision I have a curriculum for 
training, but will keep it to myself for the 
present, as it might get trampled upon by the 
high and mighty. A Pioneer Nurse. 

+ 
Helping the Undertaker. 
To the Editor of The Trained Nurse: 

I would like to ask "New Haven Nurse" 
and others if it is a general practice to charge 
for helping the undertaker? To me it seems 
heartless and horrible, at the time when we 
should be doing our utmost to comfort and 
help. The majority of nurses whom I have 
helped prepare a body for burial have shocked 
me beyond words with the disrespect they show 
the body. They will strip it naked and make 
a superficial dab for a bath. Do they ever 
think of the day when some stranger docs this 
ofiice for their loved ones or themselves? 

I will never forget the first body I ever saw 
prepared, and the tenderness and respect with 
which it was done by our superintendent, 
Mi.ss Charlotte McLeod, a lady always. Per- 
haps I am a little cranky on this subject, but 
charging for such a thing seems dreadful, un- 
leiw you go to the house with the undertaker 
as his assistant, which I often do. Then I 
charge as for any other regular call. Some 
of my happiest moments have been when I 
have been where I have been thanked for do- 
ing these things for some loved one, by those 
who were unable to do it themselves. 

Grace Marion Prue, 
Visiting Nurse. 

+ 
The Question of Fee. 
To the Editor of The Trained Nurse: 

As a trained nurse, and reader of The 
Trained Nurse and Hospital Review, may I 
put in my two cents on the subject of what a 
nurse should charge for her services? I have 
been nursing twenty-one years. During that 
time I have had as patients all sorts of people, 
with all sorts of diseases, for all sorts of 
price, from nothing a week to $5 a day. I 



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192 



THE TRAINED NURSE AND HOSPITAL REVIEW 



liave had my patient say, "Nurse, you are 
worth your weight in gold at any price" (and 
I am not by any means a featherweight), 
when they were paying $5 a day, and I have 
hal them when they could afford to pay a 
good deal more, find fault when I have 
charged a good deal less. As to the nurse's 
wages : In the first place, is not the "work- 
man worthy of his hire"? 

Speaking from my own experience, and I 
know there are hundreds in my position, the 
trained nurse is pretty much like other women 
who work for a living. We work not only 
for self-support, but a great many of us have 
some one else depending on us, some of us 
more than one. We are not only sick our- 
selves, but we have sickness in our families. 
Socially and in every other way, as far as my 
experience goes, we have as many calls upon 
our purses as any other member of society. 

I venture to say that eight nurses out of 
every ten are employed only six months on an 
average out of the year, at an average salary 
of $20 a week. Of course there are excep- 
tions. For the money we receive for six 
months' work we must provide for ourselves 
in sickness and health for the whole year and 
for those dependent on us. We must keep 
ourselves decently (not elegantly) clothed, 
both in and out of the sick room, and "lay up" 
enough to keep us when we are no longer able 
to earn our living in our profession. And this 
ue are told we must do in ten short years, for 
the average life of a nurse (I am an excep- 
tion) is ten years, they say, though I have 
known a great many who did not last that 
long. In speaking on this subject (the nurse's 
salary) to a physician, he said to me, "But, 
Nurse, a great deal of my work I know I will 
never be paid for and I do it willingly for 
charity." "Yes, doctor," said I, "but while you 
arc attending five patients for charity you are 
attending six times that many for cash, while 
the nurse is giving up and perhaps losing for- 
ever one of her best paying patients, while she 
is working for some one for nothing, or next 
door tc> nothing." And this we cannot afford 
to do. We viust live. 

A Trained Nurse. 



From North Dakota. 
To the Editor of The Trained Nurse: 

It is with pleasure I send my renewal. After 
I have read The Trained Nurse from cover 
to cover I pass it on to the public library, 
which in a small town is always glad of up-to- 
date magazines. 

I came to Grand Forks from Minneapolis 
just one year ago. I would like to say for the 
benefit of others making their own living that 
I have made here $200 over any of the previ- 
ous nine years of nursing, as well as having a 
much wider experience. 

There arc twenty-five or thirty nurses in 
Grand Forks, but yesterday a patient was 
taken to the hospital because there was not a 
nurse off duty. We are called as far as 
Minot. 200 miles out, and on the branch lines 
north or south. Some of the small towns 
have one or two nurses, but many times more 
are needed. 

The weather this Winter is delightful and, 
take it altogether, Dakota, or I might say 
North Dakota, makes one "happy, wealthy and 
wise," if you want to be so. With all good 
wishes for the continued success of The 
Trained Nurse this coming year, I am, 

Your well wisher, E. G. L. 

+ 
The Record. 

To the Editor of The Trained Nurse: 

The views of another nurse as to who 
should keep the record: Am a graduate and 
snbscriber to The Trained Nurse, and have 
been very much interested in the question of 
who should keep the record. If the doctor 
furni.«ihes the blank, the record belongs to him. 
If the nurse furnishes the blank, then the 
record belongs to the nurse. That blank is an 
article that she has bought and paid for, and 
only does professional courtesy require her to 
give it to the doctor at the termination of the 
case, should he care to have it The record 
belongs to the nurse if she chooses to keep it, 
and if she furnishes the blank. 
Very truly yours, 

A Graduate. 



ADVERTISEMENTS 




Boofe B^etitetos 



Bacteriology in a Nutshell, a primer for 
junior nurses, compiled and arranged by Mary 
E. Reid, graduate nurse, formerly superinten- 
dent Thomas Hospital Training School for 
Nurses, Charleston, W. Va. ; assistant instruc- 
tor in general nursing. Woman's Branch of 
the German Hospital, Cincinnati, Ohio; prin- 
cipal of the Traiing School and superintendent 
of nurses, Charleston General Hospital, 
Charleston, W. Va., 1905-07. Revised and en- 
larged. Price 55 cents, post paid. For sale 
by Lakeside Publishing Company. 

The second edition of this valuable book is 
considerably larger than the first edition. It 
has been increased by fifty pages, and has been 
carefully gone over and corrected page by 
page. 

I he book is compiled for junior nurses, but, 
while elementary, it is at the same time suffi- 
ciently full and clear to be of value to all 
nurses. It consists of eight chapters, of the 
foUowing headings: "Brief History of Bac- 
teriology," "The Relation of Bacteria to Dis- 
easa." "Description of the Most Important 
Bacteria," "Bacterial Invasion," "Common 
Communicable Diseases," "Bacteria in Sur- 
gery," "Solutions, Their Preparation and 
Uses," and "Hygiene for Nurses." 

At the end of each chapter there are ques- 
tions reviewing the contents of the chapter. 
The type is large and clear and the cover flex- 
ible, so that it is an easy book to carry with 
one to a case. 

There is also a better edition, with stiff cov- 
ers, for $1.10. 

It gives us pleasure to recommend this 
work to the nursing profession. 



A Manual for Hospital Nurses, by Edward 
J. Domville, L. R. C. P., London, M. R. C. S., 
England, surgeon to the Royal Devon and Ex- 
eter Hospital and to the Exeter School ; lec- 
turer and examiner to the St. John's Ambu- 
lance Association ; ninth edition. For sale by 
the Lakeside Publishing Company. Price 75 
cents, postpaid. 

When a book has reached the ninth edition 



it is a work of supererogation to state that it 
is good and useful, for it has been proved to 
be so. 

The older nurses will remember this book 
which, ten or fifteen years ago, was as much a 
standard in the United States as it has ever 
been in England. As the methods of training 
in England and the United States began to di- 
verge, and as American nursing works began 
to appear on the market, the sale of this book 
dropped off, but with its revision and ninth 
edition we believe that it has been put in 
condition to again take its place on the Amer- 
ican market 

The arrangement of this book is entirely 
different from that of any other nursing work 
on the American market with which we are 
acquainted, and is as follows: First comes 
an introduction divided into four head- 
ings: "The Nurse's Duties as Regards Her- 
self," "The Nurse's Duties Toward Her Su- 
periors," "The Nurse's Duties Toward Her 
Fellow Nurses," "The Nurse's Duties Toward 
Her Patients." 

Next is a section on ordinary cases, begin- 
ning with ventilation and bed-making, and go- 
ing down through the administration of mcdi 
cine, hypodermic injection, etc., taking in all 
of the ordinary duties of the nurse. 

Next follows a section on extraordinary 
cases, devoted largely to accidents and emer- 
gencies, operations and treatment of special 
cases, not forgetting a few pages on antiseptic- 
solutions, upon which subject nurses seem a 
little weak. 

The book closes with an appendix, taking 
in such subjects as the preparation of foods 
and remedies, bandages, baths, weights and 
measures, and glossary. Our only criticism 
is that some of the subjects treated in this ap- 
pendix would have been better arranged if 
they had been grouped with the subjects treat- 
ed under the first section. This slight fault 
does not mar the usefulness of the work as a 
whole. The book is small and can be readily 
carried to a case. We advise its purchase. 



ADVERTISEMENTS 




Stestores Sron Equilibrium, provides material for and promotes 
nutrition, inhibits katabolism and hemolosis, is anti-periodic, tonic, 
stimulates functional activity of brain, cord and sympathetic Nerv- 
ous System. 

Ss palatable, free from gastro- intestinal irritation non- constipating, 
readily and promptly assimilable, without action upon the teeth. One 
tablespoonful represents the equivalent of 

TR. FERRI CHLOR. 20 M. 

ARSENIOUS ACID Gr. 1/40 

STRYCHNINE Gr. 1/80 

S» indicated in the most severe forms of Anemia, especially that 
accompanying Chronic Malarial Poisoning, the Cachexiae, Malignant 
Disease, Sepsis, Chorea, Chronic Rheumatism, Obstinate Neuralgia, 
Adynami-a follow^ing prolonged fevers, etc. 

DOSE — One tablespoonful 3 or 4 times per day. 

THE PALISAT>E M'FQ CO. 

YONKERS. N. Y. 




*Antikamnia & Codeine Tablets" m Grippal Conditions 

W1i«n rou write Advertlaen, please mention Thb Tkaindd Ndbsi. 



Cije hospital B^ebieto 



Mount Sinai Hospital. 

The following interesting facts arc taken 
from the annual report of Moinit Sinai Hos- 
pital, which was read by the president, Mr. 
Isaac Stern, at the annual meeting held in 
Januarj- : 

There have been, in round numbers, almost 
100,000 patients treated in the hospital since 
it was founded — 'Strictly 98,022. There was a 
small decrease in the number of cases treated 
this year, compared to the previous year, due 
to the fact that the hospital was being reno- 
vated and repainted, and at least one of the 
wards was in disuse all the time. 

To the dispensary many more persons came 
than to the hospital "proper. On some days 
the number of patients treated exceeded 900, 
and during the year more than 175,000 consul- 
tations were given and more than 150,000 pre- 
scriptions dispensed. The cost of maintaining 
the dispensary was $28,000 and the receipts 
only $18,007, leaving a deficit of almost $10,000. 
The dispensary has joined with other dispen- 
saries in the warfare upon tuberculosis, and 
with each patient suflFering with that disease 
it will send out a visiting nurse to instruct the 
patient at his home in the proper care of him- 
self and in the avoidance of practices likely to 
infect those associating with him. 

In the Pathological Department active re- 
search work is continually done in the higher 
problems of modern medicine, and a number 
of important contributions to scientific medi- 
cal literature have emanated from the depart- 
ment, and several exhibitions of scientific work 
have been made before medical societies. 
There is also a Radiographic and an Anaes- 
thetic Department, and a Social Welfare De- 
partment has also lately been added through 
the generosity of Mr. Paul M. Warburg, who 
provided a sum for the purpose. Advice and 
assistance are given to patients who, when 
leaving the hospital, require aid during con- 
valescence. A trained social worker visits pa- 
tients in their homes, keeps in touch with their 
needs, and places them in contact with agen- 



cies wliich can render them financial assistance 
when they require it. 

A system of investigation of all cases where 
there appears to be some doubt as to the just 
claim for free treatment has been inaugurated. 
This will enable the hospital to discover cases 
of fraud and misrepresentation. The percent- 
age of such cases, it is reported, was less than 
was generally supposed. 

The State Charities Commission has placed 
the hospital in the class At, the highest attain- 
able, as to general condition and efficiency of 
service. The report on the dispensary also 
commends its high efficiency and general ex- 
cellence. 

The receipts of the hospital for tlie year was 
$351,827.19. The main items of this sum were 
about $103,000 from membership, about $113,- 
500 from pay patients, $18,000 from the dis- 
pensary, $8,400 from the Saturday and Sunday 
Association (the highest amount awarded), 
about $14,500 from donations, $51,709 from 
tiic city, about $12,000 from interest. There 
were many minor items. 

The di.sbursements, whicli amounted to 
$.383,057.48, included a little over $116,000 for 
food, about $32,000 for improvements and re- 
pairs and $28,000 for the dispensary. The 
disbursements sliowed an increase of $26,336.85 
over those of the year before, due, it was said, 
to the advanced cost of food, coal and other 
supplies. To make good the deficiency, the 
sum of $31,230 had to be borrowed from lega- 
cies' and bequests, which should have been 
placed to the credit of the permanent fund. 
Though the membership shows an additicn of 
463 new members, the loss of contributors wa> 
greater, and the present membership is re- 
duced actually by 332 from last year. 
+ 
Iowa State Sanitarium. 

The new Iowa State Sanitarium for tlie 
treatment of tuberculosis, located near Iowa 
City, Iowa, was opened February r. Several 
patients were on hand for the opening, and a 
large number of applications for treatment 



ADVERTISEMENTS 



"IT RESTS YOUR BACK!" 

THE NEW 




Back=Resting Corset 



TUST as the Nemo Self-Reducing Corset 
*^ has solved the stout woman's problem by 
reducing her figure with comfort and sym- 
metry, so does our new " Back-Resting " 
Corset bring health ^and perfect style to the 
woman of medium or slender build who 
suffers from a tired, aching back. 



You have never seen any corset like it — it's 
an absolutely 
new construc- 
tion, of our 
own inven- 
tion, patented 
and e'clusive. 




The back-resting 
straps give welcome 
support at the spot it is 
most needed — the small 
of the back. Relief is 
immediate, the effect al- 
most magical. And it 
{ reduces the "new figure" 
at its very best — the flat 
and slender hip effect. 



The back steels simply can- 
not turn and dig into the 
tiesh, no matter how tight the corset is laced. 
That is good news, isn't it ? 

The " Back-Resting " Corset, though entirely 
new in the market, has been thoroughly tested 
and proved. It is sold under our lull guar- 
antee that it will produce exactly the results we 
claim. 

emo " Back-Resting " Corset 

|U|\ "J CI Made of a fine quality of coutil, 
IIU* iJlI I also of batiste, in white; 
suitable for slender and 
medium figures ; sizes, 1 8 to 30, . . . 



$3.50 



E-very Nemo Corset is ma.de tuith the 
Sh(emo " Triple-Strip Re-enforcement " — 
the bones and steels can 7 cut through. 



You will find Nemo Corsets in all good stores 
throughout the world where corsets are sold. 
If your dealer can't supply you, let us know. Send for our little booklet, " Hygienic Figure- 
Building," mailed free, and be sure to mention the TRAINED NURSE. 

KOPS BROS., MANUfACTUR[R$, Cor. 4th Avenue and 12th Street, New York 



198 



THE TRAINED NURSE AND HOSPITAL REVIEW 



have already been made. The present quarters 
accommodate about eighty, and are comforta- 
ble and strictly modern in every particular. 
The State Board of Control has appointed 216 
Iowa physicians as examiners for the sani- 
tarium, the physicians to receive a fee of $3 
for each examination, to be paid by the pa- 
tient. Under the law these physicians will 
examine persons who desire to go to the in- 
stitution, and will issue certificates as to the 
exact condition of the patient. If they are 
suffering from incipient tuberculosis they will 
be admitted for treatment. Poverty will not 
be a bar to entrance, but all persons having 
means to pay cost of treatment will be charged 
$30 per month. Dr. Kirscher, late of Penn- 
sylvania, who has had large experience in this 
line of work, is the superintendent in charge. 

+ 
Iowa University Hospital. 

Iowa State University Hospital, at Iowa 
City, has lately become the recipient of $S,ooo, 
donated by Mrs. Helen J. Gifford, who lately 
died in that city. The gift is for use in es- 
tablishing a free room in the hospital as a 
memorial to her son, Walter L. Gifford. In 
the gradual administration of her estate she 
provides by will for the addition of $20,000 
more to the fund already given. 

+ 
James Memorial Pavilion. 

One of the most interesting features at the 
Northampton (Mass.) State Hospital, and one 
which is regarded as of great value in the 
work of the institution, is the James Memorial 
Pavilion, which has recently been opened. The 
building was erected in honor of the late Ly- 
man D. James, of Williamsburg, who was for 
many years a devoted and efficient member of 
the Board of Trustees of the hospital, and is 
presented by Mrs. James. The building is of 



attractive architecture and finish. Its plan is 
somewhat that followed in the erection of 
armories, with a head house, backed by the 
long, narrow shed containing the bowling al- 
leys. As the visitor enters he faces the alleys, 
which extend back from the lobby, and on 
oither hand are two commodious recreation 
rooms. The reading room on the right is 
suitably provided with books and magazines, 
and its equipment, like that of the game room, 
includes a fireplace of good size. In the op- 
posite room the minor games, like cards and 
checkers, may be played, and a pool table will 
soon be established there. Opening from each 
of these two rooms is a smaller room, one of 
which is occupied by the man in charge and 
the other used at present as a storeroom. The 
interior of the head house is tastefully finished 
in stained woods, with which the mission fur- 
niture harmonizes effectively. A bronze memo 
rial tablet in honor of Mr. James, which has 
been ordered, will be placed above the fire- 
place. 

Dr. J. A. Houston, the superintendent of the 
hospital, regards the usefulness of the new es- 
tablishment in providing recreation for the 
inmates as very great. 

+ 
Germantown Dispensary. 

The Germantown (Pa.) Dispensary and 
Hospital took title February 3 to a large lot 
near its present building, and, it is said," con- 
templates the purchase of more ground, which 
will be used as the site of additional build- 
ings. The ground to which title was taken is 
on the southeast side of Penn street, southwest 
of Chew street, and was purchased from 
James F. Magee, Jr., for a consideration of 
$10,000. The lot covers an area measuring 
2S0X irregular feet and represents an assessed 
valuation of $6,500. 



Perso 

Miss Sarah L. Cook has resigned her po- 
sition as superintendent of the Culver Union 
Hospital, Crawfordsville, Ind., on account of 
ill health. Miss Cook has been in charge of 
the hospital for several years and during her 
residence there has made many warm friends. 
She succeeded Miss Edna Humphrey, who 
was the first superintendent of the hospital. 



nais. 

Homeopathic Hospital, Iowa City, is taking 
a much needed rest at her home in Well- 
man, Iowa, before locating for private prac- 
tice. 



M'ss Effie Simmons, N. T. S., Class '07, 



Miss Katharine Rehstimer, a graduate from 
Crescent Sanitarium, Class '05, of Evansville, 
Ind., is taking a course in massage-hydro-ther- 
apy and mechano-therapy at the Pennsylvania 
Orthopedic Institute of Philadelphia. 



ADVF.RTrSEMKNTS 



Like the 

Proverbial 

Pudding, 

the proof of which 
is "in the eating," is 

"tho tfierapeuiic value of which is proven "in ihe trying."' 

That this pleasant tasting, neutral combination of organic Iron and Manganese is an efficient 

"Biood-BuildGr" in cases of Anaemia, Ghioro-Anaemia, Chlorosis, Rhachitis, etc. 

is shown in two ways : 

ist— By the obvious and rapid improvement in tlie patient's color and g:eneral appearance. 
2d— By the increased numBer of red blood cells and the greater percentage of haemoglobin, 
as shown by instruments of precision (haemocyclometer, haemoglobinometer, etc.) 

Do you want to make these tests yourself ? If so, we will send you a sufficient quantity for the purpose. 
To assure proper filling of prescriptions, order Pepto«Mangan "Gude" In original bottles ( § xi). 

IT'S NEVER SOLD IN BULK. 

M. J. BREITENBACH COMPANY, 

l*BOB*TORY. " ^ NEW YORK. 



LEIPZIG. GERMANY. 



The Physician's Baby 

should be a model infant, and usually it is. It receives every care 
that can possibly assist its development, and, of course, the 
closest attention is paid to its diet. That is why thousands of 
physicians' babies are fed 

Lactated Infant Food 

Wherever it is known, the medical profession recognizes it as 
the only adequate substitute for mother's milk. It never fails to 
improve the general health of every infant to whom it is fed. 
We will be glad to have you try it at our expense. 



Physicians who wish to give Lactated In- 
fant Food a careful trial may have tamplcs 
sent direct to patients by forwarding to us 
names and addresses 



WELLS & RICHARDSON CO. 
BURLINGTON, VT. 



3x[ tije Jtursing WBoxXb- continued 



The Minnesota Bill. 

A bill for an act to provide for State regis- 
tration of nurses and the licensing of persons 
as registered nurses. Be it enacted by the 
Legislature of the State of Minnesota: 

Section i. It shall be unlawful for any per- 
son to practise professional nursing as a regis- 
tered nurse in this State unless such person 
shall have first obtained a certificate of reg- 
istration as provided in this Act. 

Section 2. A Board of Examiners to con- 
sist of five persons, one of whom shall be a 
regularly licensed physician, is hereby created 
to carry out the purposes and enforce tlie pro- 
visions of this Act. Said Board shall be ap- 
pointed by the Governor and the other ap- 
pointments shall be made from nurses engaged 
in active work who have been graduated for 
at least a period of five years from reputable 
training schools, and whose course of train- 
ing is not less than three years' duration in 
actual hospital service; provided that there 
shall always be two of said members on said 
Board selected from nurses who have had at 
last two years' experience in educational work 
among nurses, or who have had two or more 
years' experience in the instruction of nurses 
in training schools, and provided further, that 
after the appointment of the first Board, the 
nurses appointed on each succeeding Board 
shall be appointed from the nurses registered 
under this Act 

Section 3. Each member of said Board 
shall serve for a term of five years and until 
his or her successors are appointed and qual- 
ified, except in the case of the first Board, 
whose members shall hold office as follows: 
One member shall be appointed to hold office 
one (i) year; one for two (2) years; one 
for three (3) years; one for four (4) years; 
and one for five (5) years. Each member 
of said Board shall give a bond in the sum 
of $1,000, with securities to be approved by 
the Secretary of State, conditioned for the 
faithful performance of his or her duties, and 
shall take the oath provided by law for public 
officers. Vacancies upon said Board caused 
by death, resignation or expiration of the term 
of any member thereof shall be filled by ap- 
pointment by the Governor. 



Section 4. Said Board shall elect from its 
members a president, a secretary and a treas- 
urer, and shall have its headquarters at the 
State capitol; shall have a common seal, and 
the secretary and president shall have power 
to administer oaths. , 

Section 5. Each member of said Board 
shall receive a compensation of five ($500) 
dollars per (J^y for each day of actual ser- 
vice and ten cents (10 cents) per mile for 
each mile actually traveled in attending the 
meetings of the Board, which compensation 
shall be paid out of any moneys in the hands 
of the treasurer of said Board; provided that 
said compensation and mileage shall in no 
event be paid out of the State Treasury. 

Section 6. Any money in the hands of the 
treasurer at the end of any year, in excess of 
two hundred and fifty ($250) dollars shall be 
paid over by said Board to the State Treasurer 
to be kept by him for the future maintenance 
of the Board and to be disbursed by him upon 
warrants signed by the president and treas- 
urer of said Board. 

Section 7. Said Board shall hold public ex 
aminations at least once in each year at St. 
Paul, Minn., and at such times as it may de- 
termine, and notice of the time and place of 
such examinations shall be given by a publi- 
cation thereof at least ten (10) days before 
such examination in a daily newspaper pub- 
lished at the capitol of the State, and said 
Board may give such other notice as it deems 
advisable. Any person desiring to obtain a 
certificate of registration under this Act 
shall make application to said Board therefor, 
and shall pay to the treasurer of said Board 
an examination fee of five ($5.00) dollars 
and shall present himself or herself at the 
next regular meeting of said Board for ex- 
amination of applicants, and upon said Board 
being satisfied that the applicant is (i) of the 
age of twenty-one years or over, (2) of good 
moral character, (3) has received an educa- 
tion equivalent to that required for admission 
into high schools of this State, and (4) has 
graduated from a training school connected 
with a general hospital where three years of 
training with a systematic course of instruc- 
tion is given in the hospital, or has graduated 



ADVERTISEMENTS 



A Superior Surgical Dressing 
Made from the best quality of imported Welsh Kaolin 




A most effective application in all conditions of irritation, 
congestion, and inflammation. Now sold in screw top glass jars 
which can be resealed. 



FREE to Nurses— NURSES' HANDY BOOK, containing 
much valuable data and useful information connected with a nurse's duties. 



G. W. CARNRICR CO. 

42 Sullivan Street :: :: New YorK Oity 



Wbtia 70U write Advertisers, please mention The Trained Ndbse. 



202 



THE TRAINED NURSE AND HOSPITAL REVIEW 



from a training school in connection with a 
hospital of good standing supplying a sys- 
tematic three years training corresponding 
to the above standards, which training may be 
obtained in two or more hospitals, said Board 
shall proceed to examine said applicant in 
both theoretical and practical nursing, and 
upon such applicant passing said examination 
to the satisfaction of said Board, said Board 
shall enter said applicant's name in the register, 
hereinafter provided for, and shall issue to 
said person a certificate of registration au- 
thorizing said person to practise the profession 
of nursing as a "Registered Nurse." 

Section 8. All nurses graduating prior to 
January i, 19TO, possessing the above quali- 
fications, shall be permitted to register without 
examination, upon payment of the registration 
fee. Nurses who shall show to the satisfac- 
tion of the Board of Examiners that they 
are graduates of training schools connected 
with a general hospital or sanitarium giving 
two years' training, or prior to the year 1897 
having given one year's training, and who 
maintain in other respects proper standards, 
and are engaged in professional nursing at 
the date of the passage of this Act, or have 
been engaged in nursing five years after grad- 
uation, prior to the passage of this Act, also 
those who are in training at the time of the 
passage of this Act, and shall graduate here- 
after, and possess the above qualifications, 
shall be entitled to registration without exam- 
ination, provided such application be made be- 
fore January i, 1910. 

Section 9. Graduates of training schools 
in connection with special hospitals, giving 
a two years' course, who shall obtain one 
year's additional training in an approved gen- 
eral hospital, shall be eligible for registration 
without examination before January i, 1910, 
or said graduates shall be eligible for registra- 
tion prior to said date upc n passing a spe- 
cial examination before the Board of Exam- 
iners in subjects not adequately taught in 
the training schools from which they have 
been graduated. 

Section 10. Any applicant who has pur- 
sued as a business the vocation of nursing for 
a period of not less than five years prior to the 



passage of this Act, and who presents to the 
Board a certificate testifying that he or she 
is competent to give efficient care to the sick, 
said certificate to be signed by one licensed 
physician and two registered nurses, shall 
be entitled to take a practical examination for 
State registration only during the two yeary 
immediately following the passage of this 
Act. 

Section 11. The Board of Examiners may 
issue license without examination upon the 
payment of five ($5.00) dollars registration 
fee to applicants who have been registered 
in other States having equal requirements. 

Section 12. This Act shall not be con- 
strued to apply to the gratuitous nursing of 
the sick by friends or members of the family, 
and also it shall not apply to any person nurs- 
ing the sick for hire but who does not in any 
way assume to be a registered nurse. 

Section 13. Said Board shall keep a reg- 
ister in which shall be entered names of all 
persons to whom certificates are issued under 
this Act, and said register shall be at all 
times open to public inspection. 

Section 14. A person who has received his 
or her certificate according to the provisions 
of this Act shall be styled and known as a 
"Registered Nurse." No other person shall 
assume such title or use the abbreviation R. 
N., or any other letters or figures to indicate 
that he or she is a registered nurse. 

Section 15. Said Board of Examiners may 
revoke any certificate for suffcient cause, but 
before this is done the holder of said certifi- 
cate shall have thirty (30) days notice, and 
after a full and fair hearing of the charges 
made by a majority vote of the whole Board 
the certificate may be revoked. 

Section 16. Any person violating any of 
the provisions of this Act, or who shall will- 
fully make any false representation to the 
Board of Examiners in applying for a cer- 
tificate, shall be guilty of a misdemeanor, and 
upon a conviction shall be punished by a fine 
of not more than one hundred ($100.00) dol- 
lars and not less than ten ($10.00) dollars. 

This Act shall take effect and be enforced 
from and after its passage. 



ADVERTISEMENTS 



The 



'JUlenburas Foods. 



Provide nourishment suited to the needs and digestive powers of the child from birth 
onward, according to the development of the digestive organs. 

THe ••Allenburys" MilK Food ''No. 1 ** 

Designed for use from birth to three months of age, is identical in chemical composition with 
maternal milk, and is as easy of assimilation. It can therefore be given alternately with the 
breast, if required, without fear of upsetting the infant. 

THe ••Allenburys" MilK Food ••No. 2" 

Designed for use from three to six months of age, is similar to " No. 1," but contains in 
addition a small proportion of maltose, dextrine and the soluble phosphates and albuminoids. 

THe ••Allenburys" Malted Food ''No. 3" 

Designed for use after the fifth or sixth month, is a partially predigested farinaceous food need- 
ing the addition of cows' milk to prepare it for use. 

Physicians familiar with the "Allenburys" Series of Infant Foods pronounce this to be the 
most rational system of artificial feeding yet devised. Their use saves the troublesome and fre- 
quently inaccurate modification of milk and is less expensive. Experience proves that children 
thrive on these Foods better than on any other artificial nourishment 

SAMPLE AND CLINICAL REPORTS SENT ON APPLICATION 



THE ALLEN ®. HANBURYS CO.. Limited 

TORONTO. CAN. LONDON. ENG. NIAGARA FALLS. N. Y. 



►I- ^ 

+ f 

A Drink in Fevers 

A teaspoon of Horsford's Add Phosphate added 
to a glass of cold water makes a cooling and refresh- 
ing acidulous drink for the patient during conva- 
lescence from typhoid and other febrile conditions. 

Its superiority over Dilute Phosphoric Acid, or 
any other acid, is due to the fact that it contains the 
phosphates of calcium, sodium, magnesium and 
iron, which means increased nutrition. 

Horsford's Acid Phosphate 

is more palatable and strengthening than lemonade, 
lime juice or any other acidulous drink, 

RUMFORD CHEMICAL WORKS, Providence, R. I. 



When you write Advertisers, please mention Thb Trained Norsk. 



^eto B^emefiies ant, applmmeei 



Praise from the Tropics. 
I take pleasure in stating that I have used 
your Resinol Ointment in several cases of 
eczema, and have obtained the most gratifying 
results in every one of them. 

P. DEL Valle, M. D. 
San Juan, Porto Rico. 

+ 
Wakefulness. 

Five drops of Horsford's Acid Phosphate 
in half a glass of water, taken just upon re- 
tiring, will in many cases give a dreamless 
and refreshing sleep, where a much larger 
quantity might be found to prove an excitant 
rather than a sedative. 

+ 
A Most Sustaining Nutrient. 

Bovinine is exactly indicated as a superior 
food and tonic in all diseased conditions and 
at all ages. It is not antagonistic to any 
medication, nor does it disturb the most deli- 
cate stomach. As a rectal feeding it will 
sustain a patient longer than any other nutri- 
ent. 

+ 
In Nervous Diseases. 

In the weakness and lassitude incident to 
many nervous and mental diseases, Horlick's 
Malted- Milk makes an excellent reconstruc- 
tive. It has no tendency to constipate or pro- 
duce a bilious condition like ordinary milk, 
but is easily digested and assimilated, satisfy- 
ing every nutrituve need of the system. It 
contains a due proportion of muscle, bone, 
nerve and brain-building food elements. 

+ 
To Keep the Hair from Falling Out. 

"A visit to a well known physician, and 
another to a famous hairdresser, each of 
whom was asked this question, "What shall 
be used for washing the hair when there is an 
inclination on its part to fall out?" resulted 
in the same answer from each : "Use Packer's 
Tar Soap for washing the hair." It was said 
to strengthen the hair, to keep it from falling 
out, and to be cleansing." — Isabel A. Mallon, 
Ladies Home Journal. 



The Passing of Winter. 
With the passing of Winter many an in- 
dividual without being actually sick is still 
weak and debilitated, tiring easily, witli 
greater or less susceptibility to every chang- 
ing wind. The intelligent physician promptly 
overcomes this condition by suitable medica- 
tion, and no more efficient tonic can be em- 
ployed than the well-known Gray's Glycerine 
Tonic Compound. 

+ 
Treatment of Dropsy. 

Case 4 — ^John R., forty-two years of age. 
Has been a spreer. Hypertrophic cirrhosis 
of the liver. Mitral regurgitation ; albumen, 
hyaline casts and granular casts found in the 
urine. The effusion was so great into the. 
abdominal cavity that it was necessary to as- 
pirate. Four gallons of fluid withdrawn, pro- 
ducing very decided relief, showing evidence 
a few daws thereafter of the return of the 
edema. He was placed upon anasarcin as 
above described, in connection with tonics, 
and has been comparatively comfortable ever 
since. Thomas H. Stuckv. 

Louisville, Ky. 

+ 
Possesses Many Advantages. 

In phthisical patients the well known lack 
of appetite and intolerance of various foods 
render it imperative to give remedies which 
will not in any way interfere with the 
digestive functions, while at same time con- 
trolling or alleviating the cough and other 
distressing conditions. 

Some time ago my attention was called to 
a preparation composed of a solution of 
heroin in glycerine, combined with expector- 
ants, called Glyco-Heroin (Smith). Each 
teaspoonful of this preparation contains one- 
sixteenth grain of heroin by accurate dosage. 
It is of agreeable flavor, therefore easy to 
administer to children, for whom the dose 
can be easily reduced with any liquid, or by 
actual measurement. It possesses many ad- 
vantages not shown by any other preparation. 
Arthur B. Smith, M. D. 

Springfield, O. 



ADVERTISEMENTS 



The Dangers of Cow's Milk 

THE recent epidemic of Scarlet Fever in Chicago has awakened the whole 
country to the grave danger lurking in the Milk Supply of our large 
cities. Wherever milk is used that has not been properly safeguarded 
from the cow to the consumer, the infant mortality will always be high. 

Coincident with the Chicago Epidemic there comes a Report of the British 
Royal Commission on Tuberculosis. After five years' investigation, the Commis- 
sion confirms the theory of Von Behring, that the tuberculosis of cows is a con- 
stant menace to the human race, and that consumption developed In later life, 
has often been contracted in infancy, from tuberculous milk. 

Nestle's Food 

does not require the addition of milk in preparing it for use, as it Is a complete 
diet In Itself. The basis of Nestle's Food is cow's milk, so treated and modified 
that it will be easily digested, and will resemble mother's milk in its composition, 
as closely as possible. The milk supplied to the Nestle Factories is collected 
under the most rigid precautions, from cows that are under the constant super- 
vision of the Company's Veterinarians. Furthermore, the process of manufacture 
completely sterilizes the milk. This is fully set forth in our pamphlet, "Recent 
Work in Infant Feeding." A copy of this, with samples of Nestles Food, we will 
be glad to send to any physician. 

HCNRI NESTLE, 7 2 IVarren St., New YorR. 



INSTRUCTION IN MASSAGE 

THE SYSTEM YOU WILL EVENTUALLY LEARN 

Swedish Movements, Medical and Orthopaedic Gymnastics 

Term: 3 Months Tuition Fee, $60.00 

Course in Electro-Th«rapy 

Term: 2 Months Tuition Fee, $25.00 

Course in Hydro-Therapv in all its Forms 

Term: 6 Weeks . .... Tuition Fee. $30.00 

SPRING CLASSES OPEN MAY 14, '08. SUMMER ClASSES OPEN JULY 8, '08 

7844 TREATMENTS GIVEN IN 1907 

No Bettor Clinical Exporlonco Rosslblo 

All courses may be commenced at the same time and finished within three months. 

The instruction consists of daily clinical work and practical lessons on patients referred to our clinics from 
the various Hospital Dispensaries. Original Swedish (Ling) system, and Weir Mitchell's Rest-Cure system. 
All pupils attend clinics at several city hospitals. Payments can be made to suit your convenience. Particulars 
and illustrated booklet on Massage upon request. An early application for admission is advisable. 



INSTRUCTORS 



T. D. Taggart, M.D. (Jefferson Med. College). 

Wm. Erwin, M.D. (Hahnemann and Rush Med. Col.) 

Frank B. Baird, M.D. (Univ. Pennsylvania). 

Max J.Walter (Royal Univ. .Breslau, Germany, and 
lecturer to St. Joseph's, St. Mary's, Mount Sinai 
and W. Phila.Hosp. for Women, Cooper Hosp.,etc). 

Helene Bonsdorff (Gymnastic Institute, Stock- 
holm, Sweden). 



HPennsylvania Orthopedic 
/ _ Institute). 



LiLLiE H. Marshall 

Edith W. Knight 

Helen T. Walker (St. Francis Xavier's Infirm- 
ary, Charleston, S. C, Penna. Orthop. Inst.). 

Wm. H. Montgomery (Penna. Orthop. Inst.) 

Wm. H. Montgomery (Pennsylvania Orthop.-cdic 
Institute). 



Pennsylvania Orthopaedic Institute and School of 

Mechano-Therapy (incorpor»t«d) 

1711 Green Street, PHILADELPHIA, PA. MAX J. WALTER, Superintendent 



206 



THE TPIAINED NURSE AND HOSPITAL REVIEW 



Six Years of Pulvola Prescribing. 

I have prescribed Pulvcla Toilet Powder 
during the past five or six years, and will 
state to you, frankly, that it is the best toilet 
powder that I know of. I have often thought 
it would be convenient if I had samples to 
give my patients, and just now I saw your ad 
in Albright's Office Practitioner, offering to 
send samples for the obstetrical bag. I shall 
be pleased to make good use of as many such 
samples as you may wish to send me. 

Fredk. E. Wilcox, M. D. 

Willimantic, Conn. 

+ 
Sextonol (Schering). 

Critic & Guide, Jan., 1907, discusses "The 
Nomenclature of Proprietary Remedies" and 
refers, as illustrative example, to sextonol. 
The word saves the trouble of writing 
"tabellae e sodii, calcii, ferri, mangani, quin- 
inae et strychninae, glycerophosphatibus" with 
the quantities. An attempt was made to get 
a druggist to prepare such tablets, but they 
deliquesced on the following day. An in- 
vestigation disclosed that the apothecary had 
only the glycerophosphates of lime and soda 
in stock; he therefore left out the iron and 
manganese and used the sulphates of strych- 
nine and quinine instead of the glycersphos- 
phates. Besides, the prescription cost much 
more than the sextonol tablets do. 

+ 
Just Notice This— Please! 

Ogden & Shimer, Calgary, Alta, Canada. 

Middletown, N. Y. 

Dear Sirs — ^Enclosed find an order for 7SC. 
for which please send Mystic Cream to the 

following addresses This is my fourth 

pot of your cream and I think it is well 
named, for I am always finding new uses for 
it, and it usually proves effective. A mother 
ran to me the other day with a screaming 
child who had skinned its eye in a fall, from 
the eyebrow to the lashes and along the out- 
side of the eye. 

Mystic Cream was the nearest thing I had 
at the time, and I applied it liberally and 
was surprised that the eye did not change 
color in the least. The mother was more 
surprised as the child is very fair, and she 
says the least knock leaves the skin black 
in a short time. By the next day the bruise 
was nearly healed. She is sending for a 



pot so as to have it for future use. If you 
wish you may use this for the benefit of 
others. Miss A. E. Scott, Nurse. 

+ 
Anemias of Childhood. 

Pepto-Mangan (Gude) is a very valuable 
tonic in childhood, and unlike so many of 
the ordinary hematinics it can be given with 
impunity to the youngest infant. It has 
marked alterative properties, and in strumous 
or marasmic conditions it is especially valua- 
ble. It is absorbed rapidly, and is never re- 
jected by even the weakest stomach. 

In early life its administration is best 
affected by giving it in milk, and the dose 
should range from ten drops to two tea- 
spoonfuls, depending, of course, on the age of 
the patient. 

+ 
The Coughs Following Grip. 

Dr. John McCarty (Louisville Medical Col- 
lege), in giving his personal experience with 
this condition, writes as follows: "Ten years 
ago I had the grip severely, and every Win- 
ter until 1902, my cough was almost intolera- 
ble. During January, 1902, I procured a sup- 
ply of Antikamnia and Codeine Tablets and be- 
gan taking them for my cough, which had 
distressed me all Winter, and as they gave 
me prompt relief, I continued taking them 
with good results. Last Fall I again ordered 
a supply of Antikamnia and Codeine Tablets 
and I have taken them regularly all Winter 
and have coughed but very little. 

+ 
The "Back-Resting" Corset. 

A genuine novelty — a corset that not only 
gives the wearer the "new figure" at its best, 
but actually rests the back, relieving backache 
almost like magic. 

This is the latest achievement of the well- 
known firm of Kops Brothers, Fourth avenue 
and Twelfth street. New York, makers of the 
famous "Self-Reducing" Corsets, which are 
worn by over a million stout women all over 
the world. 

The "Back-Resting" Cor.set is entirely new 
in construction — a patented invention, which, 
however, has been thoroughly tested and found 
to be all that is claimed for it. It gives firm 
support to the small of the back, by means of 
the patented back-resting straps. It is easily 



ADVERTISEMENTS 




Excuse mc-I know \vhat I 
want and I wani whai 1 asked 
for-TOA^ED CORN FLAKES 
-Good day" 



TOASTED 

The package of ihe genuine bears this signaiure I (j^IORN 





Copyriglht, 1907, Toasted Corn Flake Co. 



208 



THE TRAINED NURSE AND HOSPITAL REMEW 



adjusted and will prove suitable for all medium 
inrl slender figures. 

Nurses are especially invited to send to 
Kops Brothers for their free booklet on "Hy- 
gienic Figure-Building," which not only tells 
about the popular Nemo Corsets, but gives 
much valuable information as to the selection 
of models, the correct way to adjust and lace 
any corset, and other things which every 
nurse is sure to find useful in her profession. 
This booklet may be had for the asking. 

+ 
Attention, Please. 

The attention of nurses is called to the 
constantly growing demand for competent 
graduates in mechanical treatments, especially 
in massage, gymnastics, electro and hydro 
therapy. There are always positions open in 
these branches for qualified male and female 
graduates in hospitals and sanitariums. The 
Pennsylvania Orthopedic Institute and School 
of Mechano-Therapy, Philadelphia, Pa., offers 
a most complete course in the before stated 
branches at reasonable charges. Spring 
classes open on May 14, Summer classes on 
July 8, 1908. Max J. Walter, Supt. 

+ 
The Trained Nurse's Suit Company. 

We are glad to be able to chronicle the suc- 
cess of our advertisers, the Trained Nurse's 
Suit Company. Their advertisement has ap- 
pf ared but a few times, and not only have 
nurses of this city patronized them liberally, 
but orders have been filled from all parts of 
the country. 

A nurse may not know where she will be the 
next week, but those who have tried know 
that, wherever they may be, they can have a 
perfect fitting uniform in a few days if their 
n^easurc is on record at the Trained Nurse's 
Suit Company. 

Nurses outside of New York who may hesi- 
tate to entrust this concern with their orders 
and funds can address: 

Miss Handsfield, 236 Liberty street, New- 
burgh, N. Y. 

Miss Mina Wilson, Westport Point, Mass. 

Miss Helen Browning, City Hospital, Elkins, 
West Va. 

Mi.f.F May Purdon, corner Fifth and Lamar 
streets, Fort Worth, Texas. 

Miss E. A. Gordon, 55 Astor place, Jersey 
City, N. J. 



These ladies ordered uniforms to their own 
measurements and sent the money with the 
orders. 

Our representative has seen letters from 
them which are of the highest praise. 

+ 
* Protect Burns from Air. 

"It is of the greatest importance that the 
burned surface should be protected from the 
air. The dressing for a burn should there- 
fore be of a character to exclude the air, to 
relieve the pain, and to exert an antiseptic 
and healing effect. Unguentine is extensively 
used by the profession in the treatment of 
burns, and it has been found most efficient. 
It causes healing to set in earlier and it has 
a marked anaesthetic effect, and is also an 
antiseptic. It should be applied to the burned 
surface to the thickness of an eighth of an 
inch and maintained with a soft bandage. — 
Nezv Albany Medical Herald. 

+ 
Send for Book "The Gorham Invalid Bed." 

The Bernstein Manufacturing Company, 
makers of aseptic hospital furniture, have 
been twenty-five years perfecting their partic- 
ular line of goods, and supply many of the 
largest hospitals with steel and glass furniture, 
sterilizers, bedsteads, mattresses and pillows. 

The new Jefferson Medical College Hospital, 
Philadelphia, conceded to be one of the finest 
in the United States, if not in the world, has 
been equipped throughout by the Bernstein 
Manufacturing Company, at a cost of $30,000. 
They are sending out to all nurses sending 
name and address on postal card a most inter- 
esting book on the Gorham Invalid Bed, con- 
taining information of practical value to every 
nurse. See their adv. in this issue. It will 
be worth your while to send for their book. 

+ 
Onyx Hosiery. 

No woman needs a good, soft, well littinjj; 
stocking more than a nurse, who is continually 
on her feet. The manufacturers of Onyx 
Hosiery were the first to make a fast black 
SiOcking, and they have spent twenty years in 
perfecting their brand of hose to make thcni 
the best to be bought anywhere for the money. 
There can never be any doubt as to tlic relia- 
bility of stockings bearing the Onyx brand, as 
to durability, shape, quality or color. These 
hose are sold by leading retail stores every- 
where in the United States. If you don't 



ADVERTISEMENTS 







PHILADELPHIA ORTHOPAEDIC 

HOSPITAL AND INFIRMARY 

FOR NERVOUS DISEASES 

School of 
MASSAGE AND ELECTRICITY 

The Original Place and 
The Original Method 

Four months* course of instruction in 
Niassagc, Swedish Movements and Electricity 

Fee $75 for Massage and $25 for Elec- 
tricity. Board not included 
Payment in advance 

Lectures Given Weekly by Members of the 
Medical Staff of the Hospital 

Practice daily under constant supervision 
Certificate Given 

CClasses are formed in October and 
January. CPupils have access to the 
Wards of the Hospital and the numer- 
ous cases referred from the clinics 

For further information addresa 

SUPERINTENDENT 


The Nauheim 

O o 4-Vi c* *^® given by 
DdfLIlO means of the 

TRITON 

EFFERVESCENT 

Bath Salts 

The preparation of an artificial Nau- 
heim Bath surcharging the water with 
carbon dioxide by adding to a tub of 
water a package of Triton Salts is 
simple to the last degree. We shall be 
glad to send literature and manual of 
the Nauheim Treatment on request. 

THE TRITON COMPANY 

Schieffelin & Co. 

NEW YORK 
Sole Licensees and Sole Agents 







The 

Successful 

Treatment 

of 

Coughs 



The successful treatment of coughs 

always depends upon the extent to which general 
ais well as local vitaJlty can be raised. This is why 



GRAY'S 



Glycerine Tonic Comp. 



accomplishes results in relieving and controlling respiratory 
diseases that are seldom observed with any other remedy. 
It imparts tone to weakened tissues, promotes nutrition 
and increases vital resistance. 

A powerful tonic, a reliable reconstructive 
and a dependable respiratory stimulant. 

THE PURDUE FREDERICK CO. 
298 BROADWAY. NEW YORK 



210 



THE TRAINED NURSE AND HOSPITAL REVIEW 



know where to get them, send to Lord & Tay- 
lor, New York (see their adv. in this issue). 
+ 
Germs Enter by Mouth and Nose. 
As a wash for the mouth and teeth, or a 
gargle for the tonsils, a tablespoonful of 
Pond's Extract of Hamamelis Virginica in a 
half glass of warm water will be found very 
agreeable and effectively antiseptic — not so 
much so, perhaps, because of its immediate 
destruction of bacteria, as by reason of its 
astringent and sedative action on inflamed 
areas, thus making sensative and susceptible 
tissues less favorable locations for the growth 
and propagation of germ life, all of which 
also applies to the following combination as 
a spray for nose or throat: 
]^ Sodii Bicarb. 

Acidi Borici aS3ii 

Pond's Extract 5188 

Aq. destil q. s. ad. 3iv 

+ 
New Dropping Bottle invaluable to Nurses. 
Every one of our subscribers should send 
for this new invention, which is of greatest 
value to nurses. The bottle is made with 
glass stopper, which has droper attached, and 
is self-locking when not in use by simply turn- 
ing stopper. It will drop any liquid not too 
thick to flow easily. No trouble to clean. 
Keeps all dust from contents of bottle and 
when dropper is not in use is an airtight coh- 
tainer. The size is convenient for carrying 
several of these bottles in your outfit filled 
w»th remedies for emergency. Send twenty 
cents in stamps to Valzahn Company, Philadel- 
phia. See advertisement in this issue. 
+ 
Leucorrhoea. 
Dr. J. D. Albright says: "One of the most 
troublesome cases I was ever called upon to 
treat was one of ever and recurring liability 
to faint, in a lady who formerly had an at- 
tack of endometritis, which had been entirely 
cured, but which left a stubborn leucorrhoea 
in its wake. The curing of this latter trouble 
lias made my patient strong, and entirely re- 
moved the fainting tendency. After I had 
exhausted almost the entire materia medica, 
without more than temporary relief, I found 
an excellent remedy in Tyree's Antiseptic 
Powder, which gave immediate relief, and 
resulted in permanent cure." A trial package 
will be mailed free. Mr. J. S. Tyree, Chemist, 
Washington, D. C. 



Uses of Alcohol Free of Tax. 

The Treasury Department allows the fol- 
lowing uses to be made of alcohol obtained 
free of tax by hospitals: "Preserving speci- 
mens of anatomy, physiology, or natural his- 
tory belonging to the institution, or for use 
in its chemical laboratory for burning in 
spirit lamps, making extracts, preparing ether 
and chloroform or compounding pharmaceuti- 
cal preparations to be used exclusively in the 
treatment of patients in the hospital to which 
the chemical laboratory is attached, and not 
to be sold to any person whatever; also for 
the bathing of patients, or in surgical opera- 
tions." There are only a few easy conditions 
to be complied with in order to obtain this 
alcohol, details of which can be had without 
charge, by applying to F. O. Boyd & Co., No. 
71 Hudson street, New York. 

+ 
A Word for Passlflora. 

"I have lost considerable time and caused 
many of my patients to suffer more and 
longer than they should have done, by virtue 
of my ignorance of Daniel's Concentrated 
Tincture Passiflora Incarnata. In my prac- 
tice I consider your Passiflora a good stand-by, 
casting abominable opiates entirely out of use. 
I regard it as invaluable for neurasthenia, in- 
somnia and similar affections, and shall 
always prescribe it with the utmost feeling 
wherever indicated, and feel confident of suc- 
cess." J. B. Morrow, M. D. 

Tulsa, Okla. 

+ 
Worry Destroys Health. 

Mental strain breaks down the health al 
most more rapidly and destructively than phys 
ical disease. Notice how long it takes a man 
or woman to recover from an attack of nerv- 
ous prostration. Stimulants are useless. Some 
thing which will permanently build up is 
necessary. Nothing is so good as Scott's 
Emulsion. It builds up strength faster than 
any known food. It has been used by the med- 
ical profession for thirty years, because it 
builds strength rapidly without taxing the di- 
gestion. It is concentrated nourishment in 
easily digested form. It contains no alcohol — 
no narcotic drugs. Scott's Emulsion slips 
right into the system, immediately strengthen- 
ing and building nerves and tissues. It is of 
wonderful benefit to all who work or worry. 
Gertrude Touzelle. 



Cable of Contents 



Page 

State Registration from the Standpoint of Equity and Justice, 

Z. L. Hudson 213 

The Trained Nurse (Poem) Alice Eaton Burbidge 218 

Is THE Three Years' Course in Training Schools for Nurses Unneces- 
sarily Long ? 219 

How Much Should We Teach ? R. M. F/ielps, M.D. 226 

Hints on Aseptic Technique Clara Foster, R.N. 230 

At Least I May Be Kind ( Poem ) 233 

La Grippe Annie E. Hutchison 234 

Night Duty Anne A. Williamson . 237 

Some Experiences of a Visiting Nurse Grace Marion Prue 239 

Practical Experiences for Nurses 241 

Dream Roses H. B. Potter 243 

The Diet Kitchen Rose R. Grosvenor 245 

Editorially Speaking 247 

In the Nursing World 251 

The Editor's Letter-Box 259 

The Hospital Review 266 

Book Reviews 270 

New Remedies and Appliances 274 

The Publisher's Desk 282 




A Clean, White, Healthy Scalp 

is absolutely essential to the growth and 
beauty of the hair. 

Packer's Tar Soap 

used systematically as a shampoo is a reliable means 
of restoring and maintaining normal 
conditions of the scalp structures. 

Korthirty-five years it has been endorsed and rec- 
ommended by the medical profession as the stand- 
ard soap for the hygienic care of the hair and skin. 

Our little booklet on " The Value of System- 
atic Shampooing, "with a sample cake of soap, will 
be sent to nurses who will mention this journal. 

THE PACKER MFG. CO.. New York 



yfhm. jow write Adrertlsere, please mention Thb Tbainbd Ndbsi. 




ADVERTISEMENTS 




The DtaTP^n 
In the World 



If m (mmm] 



r' 





I 



USED IN MORE THAN 1000 HOSPITALS 

SPECIFIED AND RECOMMENDED BY 
PHYSICIANS AND TRAINED NVRSCS CVERYWHERS 

-RETAIL prices- 
No. 1, PORCELAIN. - Standard Size, - $2.50 each 
No. 2, " - Small " - 2 00 " 
No. 3, GREY ENAMELED, Standard " - 3.75 " 
No. 4. WHITE " " " - 450 " 
No. 5. GREY " Small " - 3 25 •' 
No. 6, WHITE " " " - 4.C0 " 

SOLD BY LEADING DEALERS, OR SENT BY EXPRESS UPON RECEIPT OF PRICE 
-HOSPITALS SUPPLIED AT WHOLESALE PRICES- 



"N 



-J 



MeINECKE & COMPANX 



Every Hospital SuperinteDOent, Principal of Training School or Hoipilal Buyer ihot/ia write for Meinecke & ComjMny » 
complete catalosue, h anow mely iUiutrated. WMwing that (uO lina o( "Advanced Spedaltiet" (or Hotpiul um. 



Cfje Craineti Jtutse ann 
ogjpital B^etiieto 




VOL. XL. 



NEW YORK, APRIL. 1908. 



NO. 4 



^tate ilegtfitratton from tf)t ^tantipotnt of Cquttp 

anti justice 

L. L, HUDSON, 

Prosident Nurses' Registry Association of Colorado Springs and Member of Colorado State Board of 

Nurse Examiners'. 



UNDOUBTEDLY a State Board of 
Nurse Examiners furnishes an 
excellent "coigne of vantage," where- 
from to view our professional field in its 
entirety. 

As my three years' term of service 
nears its close, I am impressed with the 
distinct educational value of such a posi- 
tion, while also appreciating the fact 
that through its agency, my opinions on 
various nursing questions have been rad- 
ically changed or greatly modified. 

In the work of enforcing the law, no 
phase of it has appealed to me more 
than that of its equity and justice ; and 
this paper is written with the hope that 
the insight gained may illumine, if as 
with a tiny candle, the pathway of those 
striving to secure State recognition of 
our profession. 

That putting a law into operation re- 
veals its strength, and its weakness, and 
demonstrates its justice and equity, is 
self-evident, nor is interest confined to 
one's own law ; for as questions arise in 
its application, one naturally scrutinizes 
the laws of other States to see if they 
will shed any light on these vexed prob- 
lems or point the way to their solution. 

State registration includes both the 



making and administering of the law, 
and carries with it a three-fold obliga- 
tion — namely, to the public, to the pro- 
fession and to the individual. 

Broadly speaking, this obligation to 
all three can best be discharged by es- 
tablishing a three-fold standard whereby 
the individual nurse is to be measured; 
one which requires her to be of good 
moral character and to have had a 
specified amount of general and voca- 
tional education. 

While seeking to gain this end, we 
must bear in mind that the "ex post 
facto" clause in the United States Con- 
stitution, by making it unconstitutional 
for a law to be retroactive, secures pro- 
tection to those who, in all good faith, 
having acquired their professional 
knowledge in the school of experience, 
are worthily following their vocation. 

For this reason the original standard 
must be as low as is consistent with the 
public welfare, while it should be "big 
with promise" for the future. 

Why the State should license any but 
the regular hospital trained nurse, I 
find is still an enigma to most nurses; 
and is due to a misunderstanding of the 
function of the State, combined with 



214 



THE TRAINED NURSE AND HOSPITAL REVIEW 



their attitude toward their own advan- 
tages, which is similar to that of the 
university graduate, skeptical of the 
value of other channels of learning. 

In the beginning, the State's position 
toward the two classes of nurses paral- 
lels that of the householder in the Gos- 
pel; and it could justly rebuke those, 
who in a narrow commercial spirit, 
would refuse State recognition of others' 
opportunities with the self-same words : 
"Friend, I do thee no wrong. Take 
that thine is and go thy way: I will 
give unto this last, even as unto thee." 

The State by this act of justice does 
not belittle hospital training; in reality 
it has given the greatest impetus -tow- 
ards perfecting it. Yet it is hard to 
convince a hospital graduate that she 
and her training are not defrauded in 
some way when an experienced nurse 
is licensed. She is positive of its rank 
injustice, for has she not "borne the 
burden and heat of the day" as repre- 
sented by her three years hospital ser- 
vice, while this other woman has been 
"out" earning $21 or $25 per week? 

Would she could be brought to real- 
ize it is not wholly a question of dol- 
lars and cents ! For in the end, she re- 
ceives full value for those same hard 
years — ^by carrying her load more easily 
than the other; by being ^ved much 
worry and perplexity through her larger 
knowledge; by her wider scope for 
blessed usefulness, and through the 
more perfect service she is able to ren- 
der! 

As regards general education, there 
is, as you are aware, a strong leaning 
towards a high school diploma, as evi- 
denced in the Maryland, West Virginia 
and original Indiana laws. 

Without entering into the merits of 
such a standard, I wish to call your at- 



tention to the accompanying clause, "or 
has received the equivalent of a high 
school education," which is an admis- 
sion that outside the walls of a high 
school can be obtained an education 
which, for practical purposes, can be 
regarded as equal in value to that en- 
joyed by its graduates. This education 
may have been acquired at a night 
school, business course, private acad- 
emy or under the tutelage of a govern- 
ess ; still it is allowed to rank with that 
provided by the high school. 

The justice of this view is never called 
in question, all admitting its fairness. 

Tlien are we not bound to be as 
broad-minded towards vocational educa- 
tion? 

Yet Connecticut's law is unique in 
that it is the only one to apply similar 
phraseology to it, for it contains this 
clause, "or has had such experience as 
said Board shall find to be equivalent 
thereto," i. e. to the present standard 
hospital training. 

I believe a law, for the present at 
least, would be more just which took 
the same stand towards both lines of 
education, and that the Boards would 
be in a better position to mete out jus- 
tice than when they are limited to so 
many years of experience, or even when 
given large discretionary powers. 

This view must not be construed as 
being inimical to hospital training, for 
perhaps more truly than of the other 
professions it can be said of us that 
"we profit enormously by the study of 
the technique of our calling," and "noth- 
ing but practice can convert knowledge 
into power"; hence even when the peri- 
od of preliminary training is extended 
to two or more years, as I believe it 
will be, the practical hospital work can- 
not be dispensed with. For that is 



THE TRAINED NURSE AND HOSPITAL REVIEW 



215 



the potter's wheel, "par excellence," 
which, more swiftly and accurately than 
any other, grinds us with our theoreti- 
cal and preliminary training into shape 
for acceptable service. 

For the benefit of the public, profes- 
sion and nurses, the laws require the 
hospitals and training schools to "main- 
tain proper standards," to quote the 
most popular phrase. West Virginia 
goes a step further and exacts of her 
non-graduate applicants that they must 
"maintain the proper standard," which 
is certainly just, as when licensed the 
honor and good name of the profession 
passes into their keeping. 

Again, Iowa probably regards it more 
as a question of thrift, rather than of 
justice, to tax her own licensed nurses 
six dollars and the outsider ten dol- 
lars ; not holding with the Levitical law 
that "Ye shall have one manner of law 
as well for the stranger as for one of 
your own country." 

In some States, all that is required of 
experienced nurses, in addition to a 
specified term of practical work, is to 
pass a practical examination, magnan- 
imously adjusting the examination to 
their limitations. 

But the misguided individual, who has 
taken a two years course in a special 
hospital, must either put in another 
year in a general hospital or make up 
her deficiencies by preparing for and 
passing an examination "in those sub- 
jects not adequately taught" (or omitted 
altogether?) "in her training school." 

I am not posted as to why this dis- 
tinction, which seems unjust, is made, 
but attribute it to the fact that back of 
the experienced nurse there is no insti- 
tution representing selfish interests to 
be combated, as may sometimes be the 
case with special hospitals. 



The use of the word "registration" 
and of the R. N. is responsible for some 
of the misunderstanding which has 
arisen regarding the function of the 
State. 

State licensure of nursing, while far 
from .euphonious, expresses exactly 
what we receive from the State. We 
are licensed — that is, authorized — to 
practice professional nursing because we 
are "duly qualified" as to general and 
vocational education and moral char- 
acter. 

It is also misleading to assert "that 
the State's approval will set upon the 
nurse a stamp by which she will be 
known to the world as 'sterling.' " The 
silversmith knows to a fraction the 
amount of alloy in his wares, as well as 
of the precious metal. He knows posi- 
tively the. outcome of its legitimate use. 

The personal characteristics, which 
make for individual success or failure, 
are forces the vState cannot, therefore 
does not, take cognizance of. Hence, 
it does n^t guarantee that each nurse, 
though "duly qualified" according to the 
prevailing standard, will prove satisfac- 
tory. Its power is limited. For ex- 
ample, men who have made their mark 
in the medical and surgical world, like 
Doctors S. Weir Mitchell, Osier and 
Howard Kelly, receive from the State 
exactly the same license to practice their 
profession as is bestowed upon the 
young man at the outset of his career, 
and who, in spite of that license, may 
never rise above mediocrity. Would it 
not be unjust to have it otherwise? 

It was suggested to our Board that it 
would be well to consider the advisabil- 
ity of passing those who merited it "with 
honor," or "with great honor." I was 
rather taken with the idea, thinking it 
might prove a stimulus to pupil nurses, 



216 



THE TRAINED NURSE AND HOSPITAL REVIEW 



until Miss Eyre, whose permission I 
have to quote her, said that was outside 
of the State's province ; and first apolo- 
gizing for the crudeness of her illustra- 
tion, but it was the only one that oc- 
curred to her at the moment, she went 
on to say that Registration was like a 
fence the State had erected for the 
nurses to jump over, and all that con- 
cerned the State was, did, or did not the 
applicant clear that fence. How she did 
it, gracefully or otherwise, was outside 
the State's consideration. She convert- 
ed me on the spot. 

The laws at present in force, are si- 
lent regarding the disposal of two class- 
es of applicants. I refer to the gradu- 
ates of defunct schools and to those 
with an immoral past. In the latter 
case, while I believe the State would not 
be justified in withholding recognition 
of honest effort at reformation, I also 
hold it would be unjust to the public 
and profession to grant the regular cer- 
tificate. This could be obviated by hav- 
ing the law provide for the issuance of 
temporary certificates, which would ex- 
pire in one, two or three years. Tlien 
at the expiration of the time specified, 
according to her conduct, the applicant 
could be dropped, or given the regular 
certificate. 

By this method the Board would just- 
ly remain in control of the situation, 
whereas, having at once received the 
regular license, the real control lies 
with the owner, who may prove a back- 
slider, strongly entrenched behind the 
well-known difficulty of securing writ- 
ten evidence against such delinquents. 

If such a course seems like putting 
the bar sinister across the individual's 
escutcheon, it should be remembered 
that she, and not the State, has placed 
it there. 



The defunct schools are apt to be in 
tiie same boat with the absent, who are 
"always wrong," for it seems to be their 
fate to be charged with all sorts of sins 
of omission and commission. When 
their graduates apply for registration 
under the waiver, what is to be done 
with them? 

The fact of these schools being out 
of existence for some time and of their 
location at a distance makes the infor- 
mation concerning them of doubtful ac- 
curacy. At least it would take time and 
money to run these reports to earth 
and thoroughly investigate them. 

Since the aim of the present day is to 
force such institutions to either close 
their doors or adopt higher standards, 
why disturb the dead? If their gradu- 
ates, by reason of years of successful 
nursing, have "made good," and they 
are "duly qualified," would not the 
Boards more truly interpret the spirit 
of the laws if in such cases they laid 
more stress upon what the applicant is 
in herself rather than upon her defunct 
school? 

At the risk of being considered either 
a renegade or iconoclast, I must dis- 
claim any attachment for the R. N. 

I have wondered at bill after bill 
being passed with a section devoted tc 
it and no protest coming from any 
quarter. 

New Jersey is the only one to ignore 
it altogether, both in her law and li- 
cense. The District of Columbia's law 
makes no mention of it, but, if I am not 
mistaken, refers to it in the license. The 
other laws, directly or indirectly, sanc- 
tion its use, and it has been lauded so 
highly one would be justified in think- 
ing it took rank with an academic de- 
gree. 

Now, why should the action of the 



THE TRAINED NURSE AND HOSPITAL REVIEW 



217 



State in licensing nurses be emphasized 
in this way? Why should our profes- 
sion be singled out for this decoration 
at the end of our names? Are lawyers, 
doctors, dentists, druggists and teach- 
ers proudly annexing initials to their 
names on being licensed to follow their 
respective professions? Not at all, and 
I do not believe we stand in need of 
this distinction any more than they do. 
Then why has it been so eagerly sought 
for in our case? I attribute it to the 
fact that, with us, no degree is conferred 
with our diplomas, and the R. N. ap- 
parently supplies this deficiency. 

Out of the present dissatisfaction 
with the prevailing scheme of nursing 
education may be evolved one which 
will follow more closely along the lines 
which have been tested and adopted in 
the other professions, while fully pro- 
viding for the peculiar needs of our 
own, and insisting that each diploma 
issued shall carry with it, according to 
the recipient's attainments, either a 
Bachelor's or Master's degree in nurs- 
ing. 

The field of nursing is broadening, 
and as the new branches are permanent- 
ly annexed to the profession they will 
call for special training. Will the State 
refuse recognition to all but those who 
manage to cover the entire ground in 
the course of their training? Hardly. 
Then how would it be possible for the 
State to deal out justice and equity to 
all? 

Scanning the methods which obrain 
in general education, we find that to 
secure the Bachelor's degree the stu- 
dent is not required to take up every 
study. 

Competent persons, better able to 
judge as to the essentials, which 
through "ignorance or caprice" might 



harmfully be rejected by the young and 
inexperienced, have selected a curri- 
culum which all must cover, and in ad- 
dition, personal choice is allowed in cer- 
tain elective branches. 

From which we see that the A. B. 
degree does not mean each student has 
taken the same courses, but that the 
general scholarship and special attain- 
ments of one are equivalent to those of 
the others. 

Why should it not be so in our voca- 
tional education? 

In the various crafts, trades and pro- 
fessions the futility has been recognized 
of forcing "square pegs into round 
holes." Would-be members of our pro- 
fession are entitled to a like considera- 
tion for their individual tastes and pre- 
ferences, and I trust the time is coming 
when the young woman who has no 
leaning towards maternity work, but a 
pronounced gift for understanding and 
ministering to the nervous and insane, 
will be exempt from doing "stunts" in 
the obstetrical ward, and vice versa, 
and that the State will license both, be- 
cause both, in addition to their special- 
ties, are equally rooted and grounded 
in the theory and practice of general 
nursing. Then State licensure will be 
just and equitable, and the cry of class 
legislation be silenced. 

Though "the spectator sees most of 
the game," the players are better quali- 
fied to testify as to the value of and de- 
fects in their individual preparation, and 
I believe a satisfactory basis could 
best be reached if a representative group 
of superintendents and teachers could 
meet and confer with corresponding 
groups of nurses from the various 
branches. They could agree upon the 
divisions of nursing education which 
must be common to all and create an 



218 



THE TRAINED NURSE AND HOSPITAL REVIEW 



elective system of the remaining 
branches, one or more of which com- 
bined with the prescribed course would 
entitle the pupil to a degree in nursing 
corresponding to that of Bachelor of 
Arts. Then the way would be open for 
the State to recognize that degree as 
"duly qualifying." 

I admit there are "breakers ahead," 



for just as we find those who "regret 
that it is possible for a man to get an 
A. B. with no real knowledge of the 
classics and mathematics," just so may 
we expect to meet with those who as 
fondly cling to "six maternity cases" as 
essential for rounding out a nursing 
education, and without which no individ- 
ual should be licensed by the State. 



Cfje CraineD JBturse 



The qualities a nurse must own 
And what she ought to be 

Would make one woman all alone 
A varied company; 

Creating of one single soul 

A curious many-sided whole. 



But the one thing she does not need, 
Though you would never guess, 
(Her patients' friends are all agreed 

She ought to do with less!) 
Is "Nature's sweet restorer, sleep," 
Eternal vigil must she keep. 



For "argus-eyed" she needs must be. 
Should have a "rubber neck;" 

An angel's temper, for, you see, 
Her own must be in check ; 

So when she fain would slam the door. 

She sweeter seems than e'er befgre. 



And what she needs the very most. 

But you must never tell ; 
Of it she'd hardly care to boast. 

Though oft it serves her well. 
To tell with straight and solemn face 
Those fearful fibs that fit each case. 



For social life she has no use, 

Nor any gaiety — 
"Prefers" to live as a recluse, 

She's but a nurse, you see — 
The strength of Hercules she needs 
To stand the strenuous life she leads. 



A mixture of a centipede 

And octopus should be 
The maid who wants this life to lead 

And join the Registry; 
Two feet scarce cover all the ground, 
Nor can two arms go all around. 



Accomplishments she should possess, 
A charming singing voice, '^ 

Though cooking is, we must confess. 
What makes the men rejoice; 

For nervous wrecks play soulful airs 

To win them from imagined cares. 



Her poor old feet should be of rock, 
Though light as feathers, too ; 

Nor must she ever seem to balk 
At aught she has to do; 

Nerves are perforce to be tabooed — 

Nor must she care for dainty food. 



Her compensations do, 'tis true. 

Make up for most she bears; 
So many things she learns to do; 

So many lives she shares; 
And what she knows of human kind 
Is really quite a bit, you'll find ! 

Alice Eaton Burbidge. 



f s tije Ctjree iearsi' Course in Craining ^cijools 
for jBtursefi ®nnecesfiartlp 3Long? 

DISCUSSION OF DR. HUGH CABOT'S PAPER, PUBLISHED IN THE MARCH NUMBER, 



Dr. Washburn. I am very much in- 
terested in Dr. Cabot's paper, to which 
I propose to take exception on one or 
two points. 

In my opinion, and in the opinion of 
nurses and others connected with the 
Massachusetts General Hospital, three 
years is none too long for the training 
of nurses. Many hospitals have been 
hampered by lack of desirable candi- 
dates for their training school in re- 
cent years, and three years ago we were 
in the same predicament. At that time 
our probationers at Simmons College 
were expected to pay $50. This fee has 
been done away with. 

In the last year we have had more 
applicants and of a higher grade than 
ever before since I have been connect- 
ed with the hospital. 

We have at least two or three appli- 
cations every day. 

It seems to me that if we deduct from 
the two years' course the three months 
devoted to obstetrical nursing — and I 
think you will admit this is necessary 
in the proper training of a nurse — and 
the two months which are devoted to 
surgical work, and the time devoted to 
the training of the nurse for private 
work (as at the Corey Hill Hospital) 
and the period of instruction at Sim- 
mons College of two months, how much 
have you left of the twenty-four months 
in which the nurse has to get practical 
experience in the wards? You will find 
there is very little time left for the ac- 
tual, practical training of the nurse in 
the wards with the patients, of which 



many months are required before the 
nurse is capable of going out and doing 
private nursing properly. 

It has occurred to me that the third 
year should be considerably more of an 
elective year than it is now. In many 
of our colleges in the freshman and 
sophomore years a general course is 
prescribed for all, such as every one 
should have for a foundation. Then, in 
the junior year, and also the senior 
year, the. student selects the studies 
along the line of the career which he or 
she intends to pursue. I believe that 
this could be done to advantage more 
than it is done in our hospitals. 

I think there should be two and one- 
half years given up to compulsory 
work, and out of that time they should 
have a course in the contagious ward, 
in the operating room, an obstetric 
course, children's nursing, and a chance 
at private and special nursing with 
some nurse who has had experience. 
Each nurse should certainly have a 
chance at surgical training in the oper- 
ating room. 

At the end of two and one-half years, 
why cannot the nurse select the course 
she wishes to pursue, whether opera- 
tive, institution or private nursing? I 
think that very few appreciate the 
great demand there is for women trained 
to take charge of a hospital, and it is 
very diflficult for' us to get names of 
women who are capable of filling posi- 
tions like these. 

The private nurse can have a further 
choice as to whether she wishes the last 



220 



THE TRAINED NURSE AND HOSPITAL REVIEW 



six months to be devoted to special 
work in the care of patients or whether 
she will be trained for office nursing or 
social work or surgical work or the 
various other branches. 

Dr. Cabot spoke of the damage done 
to the health of the nurses. I would 
like to have him prove that. The 
nurses who are graduated from the hos- 
pitals are far healthier and better able 
to take care of themselves when they 
leave than when they come in. I am 
quite sure this is a fact. 

Dr. Cabot also spoke of allowing the 
graduates of other schools to come to 
the hospitals for post-graduate course, 
and this is a serious question. There 
are plenty of graduates of other schools 
we can take, if we wish to, and let them 
in the ward for the care of patients and 
give them a special course of the last 
six months. 

It takes two years to know our 
nurses, whom we can trust and how far 
we can trust them, and whom we can- 
not trust. If you let strange women in 
to take care of the wards, the patients 
will suflFer. I think it can be done to 
a limited extent, and to a very limited 
one. But I do not believe that by this 
means you will be able to increase your 
nursing force to any very great extent 
without injury to the hospital or dam- 
age to the patients. 

Chaimtan. I think it may be com- 
forting to you to know and difficult for 
you to realize that something like this 
same discussion is going on in the medi- 
cal profession — how long the medical 
students are to be trained. I got my 
degree in three years. Students now 
obtain their degrees in four years. A 
considerable numiber say that we do 
not teach them much of anything in the 



four years' instruction, and that five 
or even six years is essential. 

When we sit down to consider this 
question, I think this idea must occur 
to most of us. We are never able to 
teach either the nurse or the medical 
student all that he or she ought or 
wishes to know. We always stop short 
in the middle. The course is continued 
after graduation. All nurses agree 
that they have learned more after grad- 
uating than before. The question is, 
what is a reasonable amount of training 
in school? 

I think we ought to hear from some 
of the training school superintendents 
upon this subject. 

Miss Drown, how docs the City Hos 
pital Training School feel on this sub- 
ject? 

Miss Drozvn. The president of the 
school is here and I would like to hear 
from him first. 

Chairman. Is Dr. Rowe here? If 
not,. I guess you will have to represent 
the school. Miss Drown, as you always 
have done. 

Miss Drown. There is one point I 
would like to speak of, and that is from 
the standard of the nurse herself. The 
statement is sometimes made that 
nurses do not care for more than two 
years' training. This may be from the 
biased point of the superintendent of 
nurses, but the fact remains that out of 
900 graduates, 100 of the two-year 
graduates voluntarily took up the third 
year of training, and I do not think one 
of those 100 graduates ever regretted 
that step, and many who have since 
taken up private work have said that 
this added year was of the greatest ben- 
efit to them. Many have taken up in- 
stitutional work and taken very respon- 
sible positions, and they all say the ad- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



221 



ditional year was of great advantage to 
them. 

Regarding the three years' course of 
training in the City Hospital, the first 
three years' class began in January, 
1906, and we will therefore not be in a 
position to judge what the standing of 
that class is until a year to come, but 
we know that so far they have fully 
met our anticipations and we see no 
reason for wishing to change back to 
the two years' course. 

Chairman. How does Miss Drown 
feel about an elective course? 

Miss Drown. We have that embodied 
in our curriculum, and the nurses are 
given the opportunity of expressing 
their wishes for the latter part of the 
third year in the different departments 
of hospital work. 

Chairman. Miss Coonahan, what do 
you say? Two or three? 

Miss Coonahan. I should say, two 
years. I believe in the practicability of 
the two years rather than in the theory 
of the third, though I may be con- 
demned for saying it. 

Chairman. I had much rather not 
call on individuals if they will rise and 
speak for themselves. 

Miss Ayers. There is one view that 
I think has not been definitely expressed 
that I have been collecting data on dur- 
ing the past year since this discussion 
came up. A majority of the graduates 
who have been privileged to have three 
years say that this is none too much and 
that they would like another year, for 
they feel that the three years by no 
means fitted them satisfactorily. They 
need another year and perhaps more. 

I have taken particular pains during 
the past year to talk with each nurse 
as she was leavincr the school as to 
what time she most enjoyed, what peri- 
od in her three years' training meant 



the most to her, and, without exception, 
they made the same reply — their third 
year had been their best year. They 
had gotten the most out of it, the work 
meant so much more to them in the 
third year, as they had done things be- 
cause they knew why they were done 
and appreciated the value of their work 
in the third year as not earlier in their 
course. 

I think, of course, in the three years' 
course, one should take into considera- 
tion the hospital in which the nurse has 
her training, whether a large hospital 
where she receives an all-round train- 
ing, or a small hospital with few depart- 
ments. 

I know personally in our owm training 
school I find it rather hard to well 
spread out surgical, medical, including 
contagious, obstetrical diet kitchen and 
operating room, and, perhaps, some ad- 
ministrative work over the three years 
so as to give sufficient training in each 
department in that time. I do not know 
how I art! to do it in two years. 

Chairman. As to the quality and 
quantity of applicants at present as com- 
pared with two years ago. The quan- 
tity has not been as much. I think we 
have had as many last year as in the 
previous years, but I had a great num- 
ber of vacancies to fill. Some of them 
were unfilled for a longer period than I 
liked. Forty nurses graduating from 
January to January makes quite a list of 
applicants that I have to consider. I 
think, on the average, a little more than 
50 per cent of all who are taken into the 
school arc finally accepted, so it makes 
a great deal of weeding. I could have 
used a great many more good appli- 
cants, but I do not think we have much 
decrease in the number, except I was 
not able to sift them as I would like to. 



222 



THE TRAINED NURSE AND HOSPITAL REVIEW 



I want to get as many points as there 
are persons present. 

Dr. Tuttle, how do you feel on this 
question? 

Dr. Tuttle. I do not suppose anyone 
would say a nurse could get too much 
education in three years. (Chairman — 
there are some who say it, you know). 
Yes, but as I understand it, the nurse 
goes to a hospital not to get a liberal 
education, but the education that helps 
her to earn her living. This is the basis 
of the problem, and the question is 
whether the three years' time she spends 
at the hospital is too much for the pur- 
pose. 

I agree with our president that a 
nurse learns a great deal after gradua- 
tion, an^ that she is not expected to 
know everything when she leaves the 
hospital. 

Considering the length of time a nurse 
is in active service (they say ten years) 
the question is, is three years too long a 
time to spend in preparation? 

Of course, it depends upon what you 
are to teach her, and you must leave oflf 
some of the refinements now taught the 
nurse if you cut it down to two years. 

Then there is something else to be 
considered. The nurse has not the 
money to pay for her tuition or her 
board, and, hence, she has to earn that 
by her work. This is the hospital side 
of it, and the nurse has to do a good 
many things while she is getting her 
education that are not so very neces- 
sary so far as her education is .con- 
cerned. It is work that must be done, 
and, considering that, I do not think 
three years is any too long. I have not 
observed that the nurses get used up. 
Certainly the nurses at the McLean 
Hospital taking the three years' course 



have no more sickness than those who 
are taking the two years' course. Our 
course is hardly a three years' course in 
the hospital. It gives our nurses a pre- 
liminary four months of time for study, 
with very little work in the wards and 
eight months at the Massachusetts Gen- 
eral Hospital, so there comes out a year 
and the hospital gets only two years' 
work as before, but gives a three years' 
course, I should be inclined to say 
three years was all right. 

I have the impression (I do not know 
if I am right) that the change in New 
York was made because they could not 
get the nurses, and they thought if they 
went back to the two years they would 
have more applicants. 

The hospitals for the insane in Massa- 
chusetts have reached the point where 
they have had to frequent the intelli- 
gence offices to get nurses, especially 
young men. 

I think New York is in just the same 
position and has been for some time, 
so I have the impression that the two 
years' course was for this reason, but I 
cannot speak with authority. 

Dr. Hugh Cabot. Mr. President, I 
would like to say that the lack of appli- 
cants was not the reason for changing 
back to the two years in New York. 
At the time the superintendent of nurses 
stated that the change was not made be- 
cause she had not sufficient applicants. 
A recent article by Dr. Ludlum, superin- 
tendent of the New York Hospital, dis- 
cusses that pretty freely. 

Mrs. Whiteside. What was that in 
Dr. Cajaot? 

Dr. Cabot. I do not know, but I can 
look it up. 

Chairman. Let us hear from the 
nurses again. We are hearing too much 
from the doctors compared with the 



THE TRAINED NURSE AND HOSPITAL REVIEW 



223 



nurses. I shall have to call on some- 
body pretty soon. 

Miss Clark, what do yon think about 
this matter? 

Miss Clark. I think the third year 
should be wholly elective. 

Chairman. How was it when you 
were in the Massachusetts General? 

Miss Clark. Two years. 

Chairman. Miss Fiske, how do you 
feel about it? 

Miss Fiske. I believe in the three 
years' course, but I agree with Dr. 
Cabot as to a good deal, although I have 
had no experience in a large hospital. 
I believe it depends upon what you are 
going to teach. 

Chairman. How do you feel on the 
question of electives? 

Miss Fiske. I think the last half year 
should be elective. 

Chairman. I have not heard from the 
outside public as yet. I shall begin to 
call on them if they do not speak up. 
Mrs. Codman, what is your opinion? 

Mrs. Codman. I really do not think I 
know enough to say anything about it. 

Chairman. None of us know. But 
what do you think? 

Mrs. Codman. I think the elective 
course appeals to me very strongly. 

Chairman. Among the district nurses 
you have, have they taken the two or 
three years' course? 

Mrs. Codman. I am afraid I cannot 
tell ypu that. I have not looked up 
their record. 

Mrs. Vaughan. As Mrs. Whiteside 
and I were members of the Board advo- 
cating the three years' training, natural- 
ly it appeared very desirable to us, but, 
of course, subject to the modification 
that time and experience would show. 

I am not quite sure that we have yet 
had sufficient experience to feel sure it 
would be desirable to make a radical 



change to two years, though I admit 
that an elective period at the end of that 
time would be of great value, giving to 
the nurse the right to choose what she 
wants in her future development, which 
the three years' course does not give. 

Mrs. Whiteside. I do not think it 
really necessary that every nurse should 
be taught every subject, and perhaps the 
elective course is the remedy. It seems 
to me some subjects should be taught 
to some nurses that are not taught to 
all, and, as Dr. Tuttle says, they can 
hardly afford to give so much time to 
their education. 

Chairman. The question of elective 
seems to be a compromise between two 
views, as most of us here will agree. 

Miss Cottle. It seems to me thai if 
the training was properly done the 
nurse must get knowledge enough in the 
two years to do the work properly that 
is required. Some one said that in the 
third year they knew the reason why 
they did things. Why cannot they 
know the reason why they do these 
things in two years? I have heard so 
many nurses say they did things be- 
cause they were told to do them, but 
did not know why they did them. If 
they have any ordinary intelligence, they 
ought to acquire knowledge enough in 
two years to take care of any sick per- 
son or take up any work. 

Dr. Badger. For the majority of 
nurses I consider a two-years' course of 
training in a general hospital sufficient. 
In the way of varied experience the 
large hospital has decided advantages 
over the smaller, but in the latter it has 
been my oliservation that the pupils are 
better trained in the care of the individ- 
ual patient. In either hospital I think 
the nurse at the end of her two years 
(lualified to enter upon private nursing. 



224 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Thrown upon her own resources, she 
will learn most rapidly from her private 
cases many things not taught in the hos- 
pital. Instruction does not end with 
graduation from the training school. 

The training schools in the large gen- 
eral hospitals are not doing their full 
duty, however, if they turn out only 
trained nurses. In these schools more 
ought to be demanded. Take the train- 
ing school at the Massachusetts Gen- 
eral Hospital, for example. During the 
past five years I have been the medical 
instructor of these nurses during their 
first two years. I am certain that at 
the end of two years those desirous of 
entering private nursing fields are suf- 
ficiently trained and experienced. But 
the full value of this hospital would be 
missed if its training stopped here. 

I would advocate a third year with 
elective courses. The special training in 
those branches not given at the general 
hospital could be arranged for in special 
institutions. For example, instruction 
in obstetrics, eye and ear nursing, in 
mental diseases and in school and dis- 
trict nursing. In the general hospital 
nurses could also be trained along spe- 
cial lines as surgical nurses, operating 
room assistants, etc. Excellent courses 
could be offered in hospital management 
in its various branches, and these 
courses could be opened for a fee to 
post graduates from any recognized 
training school. 

I think the large hospitals ought to 
offer a three years' course of training. 
The first two years devoted to making 
the "trained nurse"; the third year an 
elective for advanced work. 

At Harvard University it is possible 
to obtain the degree of A. B. in three 
years. Tlie fourth year can be devoted 
to post-graduate work or to professional 



school work. This is a great benefit to 
the students. Would not some such 
plan as suggested for the large hospitals 
serve much the same purpose for women 
studying the problem of caring for the 
sick? 

Chairman. Is Dr. Palmer here ? We 
want to hear from you. 

Dr. Palmer. I do not know that I 
can add very much to the great variety 
of very excellent ideas that have been 
expressed. Certainly we have struck a 
very vital question when we ask the so- 
ciety to discuss the question of two or 
three years. It seems to me that it de- 
pends upon the kind of training we are 
to give. I am connected with a school, 
as you perhaps know, that teaches a 
nurse district nursing. We will hear 
more about that later on. It is a very 
important part of the work. I would 
frankly state that teaching individual 
nurses in private families, three years 
does not seem too long, but to keep a 
nurse three years in the hospital doing 
strictly hospital duties, the criticism very 
often comes to me that it is an unneces- 
sarily long time, and I fail to see the ad- 
vantage that comes from it. What 1 
hear from the public is this — that the 
training is too long and the pay for the 
nurse too high for the average family, 
and I think I can see in the future, the 
near future, that there will have to be a 
shortening of the course or a lessening 
of time and consequent expense to get 
the nurses trained so that more can go 
into private families and do work at a 
less price per week. 

I am afraid I am touching a tender 
point, but my advice to our own nurses 
is not to seek to stay in a large city, 
but to go into the growing villages and 
to become a centre of educational in- 
fluence and teach the people how to Hve. 



THE TRAINED NURSE AND TTOSPTTAT. REVIEW 



225 



r have been in practice twenty-five 
years and I can see in that time a won- 
derful change on the part of the pubHc 
in knowing how to Uve, and especially 
is this true in the last dozen or fifteen 
years as to minor ailments and how best 
to care for their own health and that of 
their children. 

I think, Mr. President, the subject 
has been of sufificient interest that we 
can all see we shall need to discuss it 
more fully in the future, and I think 
this association will work out something 
for the training schools at large and for 
which this association was formed. 

Dr. Hugh Cabot. There are one or 
two points upon which I should like to 
make myself clearer. The schools to 
which what I have said particularly ap- 
plies are those of the large general hos- 
pitals with which I am familiar. I know 
less of the training schools in the smaller 
hospitals scattered throughout the coun- 
try, and much that I have said is, per- 
haps, not applicable to them. I have a 
feeling, however, that they are doing 
their work better in proportion to their 
means than the larger institutions, and 
that they turn out nurses rather better 
fitted for the work which they undertake. 

Dr. Washburn challenges my view as 
to the damage to the health of nurses — 
a position very properly taken because 
I submitted no reasons for my view. 
My belief comes largely from two 
sources. First, from personal observa- 
tion, and second from the expressed 
opinion of others in a position to know. 
My own observation leads me to the 
conclusion which I stated, because I see 
many of these nurses, not only looking 



after my patients, but coming to me for 
advice. I find many of them who seem 
to me to have lived at a pace faster than 
their strength would justify, and many 
of them have lost the indefinable some- 
thing which is necessary to the interest 
and enthusiasm so essential to good 
work. They seem to me more or less 
constantly stale, to use a term borrowed 
from athletics. As I read the published 
views of those interested in the teaching 
of nurses, I gather that the opinion 
among the superintendents of nurses is 
quite largely that nurses are worked too 
hard, and that their hours are too long 
during the period of instruction. With- 
in a year I have seen an interesting ar- 
ticle in which the statistics of a large 
number of hospitals were collected, bear- 
ing upon the question of the illness of 
nurses in training during the three 
years' course. The amount of illness, 
the mortality and the morbidity were 
considerably larger than would be ex- 
pected among an equal number of 
women of the same age under ordinary 
conditions. In considering this question 
of illness we must remember that these 
are picked women in the prime of life, 
among whom illness should be rare. 
While Dr. Washburn's view that the 
nurses under his own care leave the hos- 
pital *'far healthier and better able to 
take care of themselves when they leave 
than when they come in," is doubtless 
correct. I am by no means prepared to 
admit that this is the fact among the 
nurses in the majority of large hospitals. 
I should be interested to have the 
subject investigated further as it seems 
to me of considerable importance. 



R. M. PHELFS, M. D. 
Assistant Superinlendent Rochester State Hospital. In charge of the Training School. 



'VTO book connected with nursing 
-^ ^ work has been read by me with 
such satisfaction as the one by Charlotte 
Aikens, on Training School Methods, 
just received. I would like to be as- 
sured that every nurse in position of 
responsibility has a copy. There is lit- 
tle in it radically new, but it is full of 
sound and frank "common sense." It 
shows clearly that it comes from one 
who has in experience met and pondered 
over all these problems. It is remark- 
ably free from exaggerated expressions 
and theories. 

That training schools are to "practice 
the art" — that they are logically, doing 
schools, with an education added only 
to help the nurse to do, seems fairly 
clear. That the "essentials" for such 
doing are all that need well be in an 
ordinary (not post-graduate) course has 
good reasons given. That medical or 
literary, or any other knowledge, while 
considered helpful, is not appropriately 
a school requirement, is also taught. 
That non-resident medical men, step- 
ping in from the outside merely to give 
lectures, often wander from the essen- 
tials of the subject in varied ways, is 
fully and freely outlined as one of the 
trials of those in charge. That extras 
and specialties are best placed in a post- 
graduate form is outlined. That pupils 
enough should be provided, even if no 
arbitrary amount of preliminary educa- 
tion can be required, is fully held. That 
"taking notes" is an exceedingly poor 
method and should be an obsolete 
method of learning, accords with my ex- 
perience of both methods. That "reci- 
tations" are very necessary to keep up 



study and interest, and to make clear 
obscure portions, is also plain, and 1 
would also add the great advantage of 
having the lecturer give the quiz on his 
own work. 

Especially do I like the frank admis- 
sion of the sure fact that nurses (as, in- 
deed, also other workers) are good, 
medium and poor, and that even some 
poor ones are apt to develop some trait 
or quality that makes them successful. 
In early times they may have been all 
missionaries; now they are usually seek- 
ing an occupation. I also like a ten- 
dency to admit that success depends on 
"pleasing the patient," however much 
one would like to have it depend on 
one's learning. Not that learning is a 
drawback, but that the other is apt to 
count first. 

It is to me quite remarkable, coming 
at this time, that she discusses all these 
questions without once mentioning the 
"registration laws." She cannot be ac- 
cused of low ideals, yet she nowhere ad- 
vocates the (figurative) method of each 
taking hold of their own "boot straps" 
and all lifting themselves from a depen- 
dent service or occupation to an inde- 
pendent profession with "high stan- 
dards." I think the omission is wise, if 
analysis shows the practical result to be 
the giving a title to the more fortunate 
(probably the minority), and practically 
inviting a large increase of the lower or 
lowest grades. To do this surely does 
not "benefit the public" as a whole, anrl 
is problematic in its benefit on the few. 

But the main topic of the book, and 
the one I purposed to here "help along," 
lies in the detailed methods of teaching. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



227 



The author paid most attention to "lec- 
tures." I desire to pay most attention 
to "books." For, while I also judge the 
main and pressing need to be a good 
sensible, uniform curriculum, I yet 
judge the greatest impetus toward uni- 
formity would come with a book that 
would satisfactorily cover this desired 
ground. When we say a person has 
studied medicine or ministry or engin- 
eering, or in a high school, we know 
she has been over about such ground in 
"text books" which are available for 
comparison and will be admitted as fair- 
ly equivalent. Why not so in training 
schools? 

It will be inferred, of course, that I 
consider the question of "text book" 
not yet fully worked out, even though 
later years have brought closer approx- 
imations. For example, where is the 
text book that takes up Materia Medica 
and Dietetics as Miss Aikens pro- 
poses? I here mean a "text book" — 
one that gives just what the nurse is to 
study, and not a reference book. Such 
a book would probably be in two fair- 
sized volumes, and conform to the fol- 
lowing four rules : 

1. Place each of twelve to fifteen sub- 
jects in fairly logical sequence. 

2. Give each iits proper proportion 
of time. 

3. Give each its proper depth of con- 
sideration. 

4. Keep each to essentials. 

I am probably advancing on ground 
where I may meet dififerences of opin- 
ion, but I am only arguing for a "book" 
what the author argued for "lectures." 
For I would have the book for the lec- 
turer to follow. And why not, when 
even a literary college does this? 

No two of the few "general" text 
books begin or end alike, -nor follow 



the above rules. A tendency seems 
prevalent to write a "special" book for 
each subject, and this is usually too 
much like a reference book. For exam- 
ple, in Materia Medica I will go farther 
than the author, and venture to state 
that it is not wise to try and teach more 
than fifteen to twenty-five of the more 
"technical" drugs (like strychnia, mor- 
phine, etc.) nor more than fifty to 
seventy-five of the more popular drugs 
(like camphor, whiskey, the disinfec- 
tants, etc.). Nor would I teach any one 
of these in a "technical" way. Now, in 
the "general" books the subject is often 
slighted — in "special" books we find 
both a completeness of reference char- 
acter and a medical technicality of form, 
such that a small "medical" book might 
about as well have been used. 

Possibly this is the most gross exam- 
ple, but in dietetics there is something 
the same ; and in obstetrics, what can 
we say to finding measurements of pel- 
vis and how to measure, and many full 
pages to help diagnose the complica- 
tions of pregnancy, including ectopic 
pregnancy, heart disease and appendi- 
citis? Or what should we say to a long 
description of special bacteria? Do we 
expect nurses to make cultures and 
make microscopic distinctions that are 
even left to specialists in medicine? Or 
in anatomy and physiology, whv give 
more than a dozen muscles (those apt 
to be mentioned), or fifteen arteries and 
probably six nerves? The nurse wants 
the "practical" parts for her work, and 
those only. 

Of course, we must teach some things 
medical. But just as surely we should 
omit most things technically medical. 
To decide about any special thing, ask 
if it is practically useful in nursing 
work. Place only such things in our 



228 



THE TRAINED NURSE AND HOSPITAL REVIEW 



"text book." Have reference books 
way up to complete medical books, if 
you must have them, but only as refer- 
ence books. It would seem that there 
is a trend toward making a "liberal" 
education of the course. But this is not 
an "educational" school at all. It is a 
training school. 

Following the author's idea, it would 
seem wise to require of each lecturer to 
follow some detailed framework or 
synopsis of subjects. Personally I have 
met this by giving each pupil a type- 
written, mimeographed copy, full, yet 
synoptical of each lecture, these having 
accumulated in the past seventeen years. 
I used to advocate letting each one 
develop his own subject. I would now 
limit them by at least such a synopsis. 

I will, therefore, venture still farther 
and present a general list of the sub- 
jects, calling the whole study time avail- 
able to be ioo%, and assigning my idea 
of the approximate proper proportion 
due each one: 

1. Nursing — its history, charac- 
teristics; nursing etiquette and 
customs 4% 

2. Anatomy and physiology 15% 

3. Medical applications, emergen- 
cies (lecture part) 7% 

4. Hygiene (principles of) 2% 

5. Hydrotherapy (theory of) 3% 

6. Surgery and bacteriology 15% 

7. Fevers (including those of chil- 
dren) 9,% 

8. Miscellaneous diseases (includ- 
ing some for children) 3% 

9. Obstetrics and gynecology 
(including infantile diseases). . 15% 

10. Dietetics (lecture part only). . 6% 

11. Massage (lecture pan only).... 3% 

12. Materia Medica 9% 

1 3. Insanity 4% 

14. Electricity (only magnet, com- 



pass and use and care of the 

three batteries) 3% 

15. Ethical, moral and business 

relations of nurse) 2% 

Total available time 100% 

I hardly suppose any of the above 
would be omitted, but the above approx 
imate proportion might possibly meet 
diflferences of opinion. The order of 
study is vexing. One wants each one 
to come first. But the above does fairly 
well. I am inclined to think the best and 
most normal method is to study along 
with the doing. If one figures on three 
years, and omits twelve weeks in Sum- 
mer, this leaves forty weeks per year. 
Of these, four weeks are profitably spent 
in review and examinations. This leaves 
108 weeks of active class study in the 
three years to divide up as above. 

Having ventured so far in putting 
forth a plan for criticism, I will venture 
farther, largely for the sake of illustrat- 
ing the principle maintained above. The 
author has, in less defined way, given 
her advised outline for dietetics. I will 
take the subject of Anatomy and Physi- 
ology for my example. Suppose the 
15% above assigned to mean fifteen lec- 
ture meetings: 

I. The (superficially) elementary parts 
of the body. (This is a preliminary, 
"bird's-eye" view.) The Skin — Quali- 
ties, layers, uses, sweat glands, sudorif- 
erous glands, hair, nails. Muscles — 
Color, locations, qualities, fibre arrange- 
ments, functions. Fat — Locations, uses, 
qualities. Blood — Parts of, quantity, 
location, uses. Lymph and Chyle — Lo- 
cation and use. Bones — Locations, 
structure, use, periosteum. Cartilage- 
Locations, qualities, use. The same for 
Ligaments — Areolar tissue and nervous 
tissue. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



229 



2. The Organs of the Body. (An- 
other preHminary view, leaving details 
for later study.) 

(i) Of Digestion. 

(2) Of Excretion. 

(3) Of Circulation. 

(4) Of Respiration. 

(5) Of Special Sense. 

(6) Of Special Secreting Glands. 

(7) Of Ductless Glands. 

(8) Of Reproduction. 

3. General study — Body made up, 
how, microscopically? how, chemically? 
protoplasm, what? cell, what? "life," 
what? "growth," what? dififerentiation, 
what? reproduction, what? "design" in 
structure ; surface anatomy names, re- 
gional anatomy. 

4. Bones — Name and location of each 
(except internal bones of head and spe- 
cials of Carpus and Tarsus) ; names of 
a few large prominences and depres- 
sions; cavities of body; joints and their 
structure. 

5. The Circulation — Heart, size, loca- 
tion, structure, cavities, valves, pump ac- 
tion ; right and left hearts. Arteries — 
Locations, structure, action of. Veins 
— Structure and action and location. 
Capillaries. Valve actions — Location of 
each. Names — Seventeen arteries, six 



veins. Forces propelling blood. Fol- 
low blood — Heart beats and pulse. 

(Space will not allow to follow fur- 
ther in detail. I will add the other 
topics.) 

6. Circulation (continued). 

7. Respiration. 

8. Digestion. 

9. Digestion (continued). 

10. Lymphatics. 

11. Muscles. 

12. Nervous System. 

13. Special Senses, 

14. Special Senses (continued). 

15. Physiological (problems of), life- 
growth, waste, repair, heat and force 
and reproduction. 

16. Elementary principles of embryol- 
ogy and biology. 

I have no space to speak of demon- 
strations, clinics, drills or other practical 
work. I am only arguing for a detail of 
the whole course as above, so plain that 
teachers may follow, and thus get 
uniformity. 

To the half-formed plea that nurses 
may teach, I have no objection, except 
the main one — that I hardly believe 
nurses of the breadth and reserve 
knowledge desired are to be found in 
suflficient numbers as vet. 



"Solace/' 

Oh, trust thyself to Him above 
When thou art tried with pain ; 

No power for prayer — the only thought 
How to reduce the strain. 



Then is the time for proving 

His mighty love for thee; 

Then is the time for singing 

"His Grace sufficeth me !" 

Dorothea Alhkr. 
Turner's Falls, Mass. 



tntfii on aseptic Ccdjntque 



CLARA FOSTER, R.N. 



Dk. ALBERT MORROW, in his 
recent book, "The Immediate 
Care of the Injured," remarks : "The 
subject of Sepsis and Antisepsis is con- 
sidered to be one of the most important 
of modern surgery." To this statement 
we must all agree, and indeed it seems 
that we might almost say the most im- 
portant, since it is possible that the most 
skilful and brilliant surgery may be ren- 
dered worse than useless by failure to 
observe the smallest point of the asep- 
tic technique of the operation. By one 
little oversight or lack of absolute con- 
scientiousness on the part of the nurse 
who prepares patient, room or material, 
the most important and careful work 
may be brought to naught. The "golden 
rule," than which there can be no better 
guide in nursing, applies with great 
force in all such preparation. If the 
nurse will ask herself, "Would this be 
safe for me? Could I trust my life here, 
as far as asepsis is concerned?'' and be 
governed accordingly, there is Uttle dan- 
ger that anything will be forgotten or 
carelessly done. But there must be un- 
derstanding of what we are doing, and 
why. No one, however conscientious, 
can work intelligently in the dark. 
"Therefore" (if we may be permitted to 
quote from a very old authority), "get 
knowledge, and, with all thy getting, get 
understanding." . 

Sepsis, from a Greek word, meaning 
putrefaction, is a condition due to the 
entrance and multiplication of microbes 
in a living organism, whereby inflamma- 
tion, with more or less disturbance of 
the general system, is produced. 

Antisepsis is the term applied to a 



method of treating wounds which aims 
at the destruction of microbes. 

Asepsis means freedom from septic 
material, and is the aim of all modern 
surgery and the end toward which the 
efforts of every nurse who has anything 
to do with wounds should be directed. 
In other words. Asepsis prevents the 
entrance of germs into a wound. Anti- 
sepsis, taking their presence for granted, 
tries to destroy them. 

Antisepsis was a long step forward, 
making possible results which had hith- 
erto only been dreamed of ; but the mod- 
ern surgeon, instead of trying to kill 
bacteria by the use of more or less poi- 
sonous substances, endeavors to keep 
the wound free from these organisms. 
It is not easy to draw an exact line be- 
tween the two methods, as it is generally 
believed that treatment cannot be strictly 
aseptic without employing means of dis- 
infection — that is, antiseptics. 

Lister and his immediate followers 
used the famous "Carbolic Spray," act- 
ing on the believe that the mischievous 
germs pervaded the air and from thence 
settled in the wound; but more than 
twenty years ago it was demonstrated, 
chiefly by the investigation of Robert 
Koch (1881 -1888). that the atmospheric 
microbes were mainly of an inocuous 
character, and that infection was essen- 
tially established by contact. The rec- 
ognition of this fact greatly simplified 
proceedings, did away with the spray, 
and saved wounds from contact with 
irritating solutions, such as bichloride of 
mercury and carbolic acid. 

When we once grasp the main points 
— that the microbes are "everywhere 



THE TRAINED NURSE AND HOSPITAL REVIEW 



231 



l)rcscnt and everywhere adherent," that 
if carried into or deposited on the 
wound they cause the various troubles 
that the surgeon dreads — suppurating 
wounds, septicaemia, pyaemia — and that 
' infection is estabhshed by contact, the 
observation of surgical cleanliness be- 
comes a habit — second nature, as it 
were. But even then, as Dr. Carl Beck 
truly remarks, "Aseptic virtues arise 
more from a touch of character than 
from a capacity acquired by education. 
Some nurses are born aseptic, others 
can never become so, no matter how 
often they are admonished." What an 
eminent surgeon calls "the aseptic con- 
science" is not, alas, possessed by all 
nurses, but appears to be a special gift 
to a favored few. We fear some of our 
surgeons would say, "to a precious few." 

Of what avail is it to scrub religiously, 
sterilize and resterilize, and then in an 
unguarded moment brush back from the 
face a rebellious lock of hair a moment 
before using the supposedly sterile hand 
to pass to the surgeon a sterile sponge 
which is introduced into the abdominal 
cavity? Or to place a sterile dress'ng 
or instrument upon an unclean (always 
meaning surgically clean or unclean") sur- 
face, as a bed or stand, and then replace 
it with the dressings or instruments sup- 
posed to be irreproachable? Consist- 
ency, always a jewel, must exist in all 
proceedings that have asepsis as their 
aim. 

Of course, the ideal of the nurse is 
such personal cleanliness and cleanliness 
of rooms or wards with which she has 
anything to do that accidental contact 
with sterile material can do no harm. 
But we all know that however we mav 
strive for this ideal, it is impossible of 
attainment in our busy, hurried lives, 
where we must do the next thing that 



comes to hand, and "do it now." It is 
never safe to assume that we or our sur- 
roundings are surgically clean. 

Any unnecessary running about of 
doctors and nurses during an operation 
shows a defective comprehension of 
aseptic principles. It is not only that 
any dust in the air or in the room (of 
course we understand that none is sup- 
posed to be there) may be disturbed, but 
the danger of contact with unsterilized 
articles is increased also. Everyone 
should know their place and keep it, not 
trying to see or hear anything but that 
which concerns their own particular 
duty; remembering that through any 
lapse of memory, attention or conscience 
on their part a valuable life may be lost. 
It matters not in the least how small or 
seeminglv unimportant the duty alloted 
to them may be, "a chain is no stronger 
than its weakest link," 

The modern operating room, with its 
marble floors and walls, round corners 
and complicated sterilizing apparatus, 
renders it comparatively easy to attain 
the results we desire ; but, fortunately, 
success does not depend so much upon 
these surroundings as upon the consist- 
ent carrying out of aseptic principles. 
Once having grasped the fact that infec- 
tion comes through actual contact (and 
not from some vague, undetermined 
danger floating in the air, it becomes 
possible to operate successfully under 
the most adverse circumstances. We 
have only to be sure that no material 
that is not surgically clean comes in con- 
tact v/ith the wound, either by direct 
means or indirect. 

Therefore, in an emergency, with but 
little time and poor surroundings, see to 
it that the field of operation, hands of 
surgeon and assistants and all material 
used are absolutely clean, and then 



232 



THE TRAINED NURSE AND HOSPITAL REVIEW 



disturb the surroundings as little as 
possible. 

This brings us to the importance of 
the mechanical method of disinfection. 
It is at once the most effective and the 
most reliable means by which asepsis 
can be attained, and nothing can take 
the place of thorough and energetic 
work with scrubbing-brush, nail-cleaner, 
etc. In fact, if the writer personally 
were compelled to choose between 
chemical and mechanical means of dis- 
infection, in preparing for an important 
operation, she would unhesitatingly re- 
linquish the former, trusting, rather, to 
soap, hot water, scrubbing-brush (and 
what is known in vulgar parlance as 
elbow grease) than to the strongest dis- 
infectants. But, fortunately, no such 
contingency is likely to arise. The ma- 
terials necessary for both methods are 
easily procured, even in the poorest 
abode, and we must use all possible 
prophylactic measures and then never 
feel too sure that we have routed the in- 
visible foe. 

Dirt under the finger-nails, no matter 
how long it has been kept in a strong 
antiseptic solution, may still contain 
germs of sufficient vitality to produce 
infection, if the mechanical process of 
cleansing has not been well carried out. 
The finger-nails should be trimmed 
smoothly, and kept as short as possible 
without injury to the fingers. Dr. Rus- 
sell Fowler says, "The only way to dis- 
infect the subungual spaces is to destroy 
them." 

After the mechanical removal of germs 
from the skin, they are still brought to 
the surface from the depths of the skin 
by the action of the sweat and sebaceous 
glands. It is known that a hand which 
has been scrubbed clean and which gives 
no culture will, upon being moved about 



for a few minutes, give a culture. To 
obviate this danger, strong disinfectant 
solutions are used for the hands, nota- 
bly Permanganate of Potash, which con- 
tracts the tissues and impedes the action 
of the sweat glands. No one has ever 
felt quite satisfied with our present 
methods of hand disinfection. The 
wearing of sterilized rubber gloves seems 
to do away with the danger, but it is 
worse than useless to don sterile gloves 
until after thorough mechanical disinfec- 
tion of the hands. Tliere is no room for 
laziness in prophylactic measures. 

Boiling water is the most powerful 
germicidal agent known. It is said to 
destroy all forms of cocci in from one 
to ten seconds, and even the spores of 
the bacillus anthracis in two minutes. 
Steam destroys the spores in fifteen 
minutes, while the tubercle bacilli re- 
quire twenty minutes. A i% solution 
of Bichlor. of Merc, fails to destroy the 
spores of the bacillus anthraces in 
twenty-four hours. 

Boiling water is so manifestly supe- 
rior to all disinfectant solutions, in the 
prompt and certain destruction of mi- 
crobes, that it should be substituted for 
them whenever it is possible to do so. 
All chemical disinfectants are more or 
less escharotic in character and the deli- 
cate tissues of the body are better 
kept from contact with them whenever 
possible. 

The best method of sterilizing instru- 
ments is by boiling soda solution (one 
tablespoonful of carbonate of sodium to 
a quart of water). It is not only a 
prompt and powerful bactericidal agent, 
but it prevents the rusting of the instru- 
ments, which is likely to occur if plain 
water is used. All pyogenic microbes 
are said to die in a i% boiling soda 
solution in from one to three seconds. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



233 



rnstruments, however, should be boiled 
from ten minutes to half an hour, and 
this just before they are used. Cutting 
instruments should be given less time, 
as the delicate edges may be injured by 
prolonged boiling. Knives should be 
boiled from two to three minutes, while 
edged instruments having locks, such as 
scissors and bone-cutting forceps, re- 
quire five minutes. Always use enough 
soda solution to cover the instruments, 
and the sterilizer should be covered. 

For dressings, gauze sponges, towels, 
etc., fractional sterilization is the method 
employed ; that is, sterilization by steam, 
at a temperature of 212° F., for half an 
hour each day on three successive days. 
The last sterilization, however, should 
immediately precede the operation. 

In the preparation of all dressing ma- 
terials strict asepsis of hands and of any 
instruments or utensils used must be 
observed. 



' All the numerous details of prepara- 
tion for operation, dressings and after- 
care of patients will doubtless have been 
acquired by the nurse during her days 
of training, and her knowledge of the 
underlying principles of asepsis should 
enable her to apply them in her future 
work, under any circumstances that may 
arise. Details of method will vary some- 
what with the ideas of the individual 
surgeon, but the principles are always 
the same, and in spite of the rapid march 
of scientific knowledge, it seems that' 
they must always remain the same, since 
the theories that have led the technique 
to its present stage are all capable of 
confirmation by bacteriological tests. 

Finally, never forget that "If ninety- 
nine points in the prevention of infec- 
tion have been observed, and the one 
hundredth point omitted, the result may 
be just as bad as if no precautions what- 
ever had been taken." 



"at iCeast 3 M^V ^t Hmti" 



So great the world, so small am I, 

So trite my daily round ; 
So many stronger, nobler souls 

For greater tasks are found ; 
But shall I pine with idle hands 

And to the truth be blind 
That in a world of aching hearts 

At least I may he kind? 



Not wise, nor great, nor panoplied 
With riches and success; 

I walk through still, sequestered ways 
In humble, lowly dress; 

Yet pilgrims there I daily meet 
And many a drear spot find, 

Where I may leave a bit of cheer- 
Remembering to be kind. 



Kind as the Master ever was, 

In deed, in word, in thought ; 
With gentleness that never fails 

And love that is not bought; 
This is the goal toward which I strive 

That I may leave behind 
No bitter memories to disprove 

That I at least was kind. 



iLa (grippe 



ANNIE E. HUTCHISON. 



EPIDEMIC catarrhal fever, contag- 
ious catarrh, influenza, la grippe — 
or its abbreviated equivalent, grip — are 
dififerent names for the same disease. 
Some medical writers claim that the best 
name for the disease is epidemic ca- 
tarrhal fever, and certainly there is an 
impressiveness in this name that the 
sufferer feels to be entirely in keeping 
with the symptoms. The name La 
Grippe seems to have been applied to 
the disease on account of its sudden on- 
set, the term being presumably derived 
from a French word that means to seize, 
and the appropriate suggestiveness is 
probably what has made this name the 
one in most popular use. Many people 
are probably accustomed to regard la 
grippe as an aflFection dating from the 
great epidemic of 1889-90; but authori- 
ties assure us that it visited America 
twice before during the century, and 
that Europe suffered considerably more; 
that, in fact, authentic records exist to 
show that the disease has occurred in 
repeated epidemics for several centuries, 
at least, and that it has very probably 
existed from early times. 

Ea grippe is recognized as one of the 
acute diseases due to a specific infection, 
but the causes that lead to any sudden 
outbreak or general epidemic are not 
understood. Neither age, sex, social 
position nor occupation seems to have 
any predisposing influence, one person 
being as liable to attack as another. It 
is said, however, that adults are more 
prone to the disease than infants or very 
young children. People living in unsan- 
itary surroundings appear to be no 
more likelv to be affected than other?. 



although its effects are likely to be more 
severe in such cases. One attack of la 
grippe does not give immunity. On the 
contrary, it seems to render the victim 
more susceptible to attack in future. 

The symptoms of la grippe vary 
greatly in different cases, and, of course, 
vary in intensity in different cases, some- 
times one symptom or one set of symp- 
toms being specially marked and in 
other cases some other symptom being 
the most prominent feature. The onset 
of the disease is usually sudden. The 
patient may have chilly sensations or 
perhaps a pronounced chill followed by 
fever and a catarrhal inflammation of 
some part of respiratory tract. There is 
likely to be headache and loss of appe- 
tite; and other symptoms that may be 
present are acrid discharge from nose, 
cough and expectoration, pain in back 
and various parts of body, nervous dis- 
turbances and gastric disturbances. In 
one type of the disease, the neurotic or 
nervous type, the nervous symptoms are 
very marked, the patient having severe 
headache, pain in the eyeballs, neuralgic 
pains in various parts of body and espe- 
cially in back, which may be tender to 
the touch, being feverish, restless and 
sleepless, in rare cases even delirious. 
Hearing may be affected temporarily, 
also the sense of taste and smell. In 
many cases the catarrhal symptoms are 
the most pronounced, there being a ca- 
tarrhal inflammation of the nose, throat 
or bronchial tubes, or perhaps the mu- 
cous membrane of all three may be 
affected at the same time. If the ca- 
tarrhal inflammation affects the nose the 
patient will have in aggravated form all 



THE TRAINED NURSE AND IlUSlTfAL REVIEW 



235 



the disagreeable symptoms of a cold in 
the head; if located lower there will be 
cough and probably some difficulty in 
swallowing or breathing. Catarrhal 
symptoms, though generally associated 
with la grippe, are not always present. 
Another type of the disease is the gas- 
tric or gastro-intestinal, in which there 
is a catarrhal inflammation of the diges- 
tive tract. When the disease assumes 
• this form the gastric disturbances are 
most marked, the patient having coated 
tongue, probably suffering from nausea 
and vomiting, severe pains in abdomen, 
diarrhoea or even dysentery. In these 
cases the nervous symptoms are gener- 
ally also present, and the patient will 
have complete loss of appetite. Other 
types of the disease are the cardio-pul- 
monary, which is specially dangerous in 
the aged, and the febrile type, which is 
most common among children. An 
almost constant feature of the disease is 
great depression of spirits and a pro- 
nounced debility. From the very first, 
prostration out of all proportion to the 
severity of fever and other symptoms 
may be present, and it is one of the most 
frequent after-effects of the disease, the 
prostration often remaining in marked 
degree long after the acute symptoms 
have passed away. Chill, followed by 
fever, is one of the commonest symp- 
toms, and the writer has observed a 
number of cases (all occurring in the 
same locality during the same local epi- 
demic") in which chills were one of the 
most pronounced features of the disease, 
the patients during the first two or three 
days suffering from rigors as severe as 
those of ague and finding it well nigh 
impossible to get comfortably warm. 
After the initial chill the temperature 
perhaps rises to iot, or ranging from 
that to 103, or it may be much higher. 



The fever stage generally lasts from two 
to three or four days, after which the 
temperature may become subnormal; or 
the fever may linger for a week. In the 
gastric or gastro-intestinal form of 
la grippe the symptoms sometimes 
strongly resemble those of typhoid, and 
in the nervous type the symptoms may 
resemble cerebro-spinal fever. 

Although la grippe is said to have 
had a large mortality in some epidem- 
ics, it is not usually regarded as severe 
in itself. Considering the great numbers 
of persons affected the mortality is very 
small. The danger seems to lie in the 
liability of some complications arising 
during the convalescing stage, the dan- 
ger being more from the diseases that 
are apt to follow la grippe than from la 
grippe itself. The most common com- 
plications are bronchitis and pneumonia 
in various forms, the latter being always 
very serious. We are told that typhoid 
fever frequently attacks patients suffer- 
ing from the after effects of la grippe, 
this no doubt being due to the fact that 
the powers of resistance against infec- 
tion are lowered by the debilitated con- 
dition following the disease. Meningitis 
occurs as a complication in some few 
cases. It is always serious and often 
quickly fatal. Neurasthenia' develops in 
a considerable number of cases, and in- 
sanity has been known to result in some. 
Diseases of the eye and ear are also 
classed among the after effects of la 
grippe. The aged are particularly sus- 
ceptible to the comphcations that in- 
volve the respiratory tract, and in the 
case of the aged and feeble such compli- 
cations arc, of course, especially grave. 
In those cases where the catarrhal in- 
flammation has been a pronounced fea- 
ture, pulmonary complications are most 
liable to occur. The bronchitis that 



236 



THE TRAINED NURSE AND HOSPITAL REVIEW 



sometimes follows may assume a grave 
type and prove almost or quite as severe 
a complication as pneumonia. 

As regards treatment there are doubt- 
less a majority of cases that do not call 
in the services of either doctor or nurse 
and make a good recovery without the 
aid of either; and in a good many in- 
stances, where a nurse is called to a case 
of la grippe, it is apt to be of a severe 
type or the danger of complication im- 
minent. The la grippe patient should 
remain in bed as long as there is fever 
or pain. An abundance of fresh air, 
without draughts, should be secured, and 
as long as the prostration continues 
every precaution should be observed to 
avoid taking cold, and overexertion 
must also be guarded against. During 
the fever stage, liquid diet is advisable 
— milk diet — or, if desirable to vary the 
monotony, expressed beef juice, beef 
tea, broths or some of the patent food 
preparations may be used. During the 
convalescing stage a specially nourish- 
ing diet is required, which does not 
mean that the patient must be prevailed 
upon to eat a great quantity of strong 
food, but that it is essential to provide 
food that, while not overtaxing the di- 
gestive organs, will be ample in quantity 
and sufficiently nourishing in quaHty to 
build up the strength. In the dieting of 
patients, special conditions in individual 
cases must of course always be taken 
into accoimt, as a food that may prove 
of great value in one case cannot be 
absolutely relied upon to have a similar 
efTect in the next. 

The treatment of la grippe generally 
includes a purgative at the start, and if 
nccessarv some laxative medicine to 



keep the bowels free afterwards. The 
skin must be kept clean and active. 
Warm baths are otten used with good 
results, these having a beneficial efiect 
upon skin and kidneys. A bath will 
sometimes be all that is necessary to 
soothe a restless patient. If a patient 
suffers much from headache a foot bath 
will sometimes give marked relief, or 
the result may be better if lower limbs 
are also immersed. Hot fomentations 
may be used to relieve pain in abdomen 
or in region of stomach. If the pain in 
back over region of kidneys is very se- 
vere, hot fomentations, hot turpentine 
stupes or hot-water bag may be used to 
give relief. In cases where there are se- 
vere pain and great sleeplessness, ten 
grains of Dover's powder is often or- 
dered with good results. In convalescing 
stage stimulation may be necessary, and 
to watch for any condition indicating its 
need and to be vigilant to detect and 
report as early as possible any symptoms 
that may arise which point to some com- 
plication is always an important duty 
of the nurse in charge of a la grippe pa- 
tient. As in everything else the treat- 
ment varies and must depend upon the 
particular form the disease assumes 
and upon the special symptoms and 
needs of the individual in each case. 
Fortunately the nurse's responsibility 
rarely extends to the selection of treat- 
ment, her duty as to treatment being 
confined to the faithful carrying out of 
the physician's orders, which duty she 
will be all the better equipped for by 
learning all she can about the nature of 
the disease, its varying symptoms and 
typyes, and the special complications that 
are likely to threaten the patient. 



iaigi)t ®utp 



ANNE A. WILLIAMSON, 

Night Superiutendent California Hospital, Los Angeles. 



\Z ERY little has been written about 
• ^ what is perhaps the most impor- 
tant branch of nursing, namely, "night 
duty." 

Night duty, the bugbear of the pupil 
nurse, the special aversion of the grad- 
uate. 

We often hear graduates say, "I never 
take night duty; I cannot sleep in the 
daytime." After I have followed their 
movements for one or two days, I do 
not wonder they find it impossible to 
sleep under the circumstances with 
which they surround themselves. 

In the first place, for breakfast they 
drink strong coflfee, then they dress and 
go out, do shopping, make calls, etc. 
Returning about noon they sit around 
the house, eating candy, cakes and other 
indigestible food, with perhaps a cup of 
tea, and when they are thoroughly 
aroused and stimulated for the business 
of the day, retire to their rooms and 
wonder why they cannot sleep. Never 
go out in the morning. The sun is too 
much of a "waker up," and if sleep is to 
be induced at a time when nature is not 
inclined to allow it, don't let "old Sol" 
have a chance at you or all is lost. 

Having for many years made a suc- 
cess of night duty, I gladly give to my 
fellow sufTerers (?) some of the rules I 
have laid down for myself. 

In the first place, the night nurse 
should have a good breakfast ; she is 
tired and hungry, and sleep will not 
come to anyone with an empty stomach. 
She must not drink coffee. I-t makes no 
dififercnce if she is positive that coflfee 
will not keep her awake. It ought to, 
for caffeine, the active principle of cof- 



fee, has a particularly stimulaimg ciiect 
on the brain and sliould be avoiueu 
when sleep is desired. Alter breakiast 
go to bed at once; no walks, no drives, 
no visiting; go at once to your room, 
take a warm bath and go to bed. Be 
sure you are warm. In the Winter time 
hot-water bags or soapstones will have 
to be used, for in the early morning 
hours the night nurse gets chilled 
through, and it will be some time before 
she is warm enough to sleep unless arti- 
ficial heat is employed to warm the bed. 
The room, on the contrary, should be 
cool — or even cold — and dark; have the 
heat turned off and the windows open, 
but the shades should be drawn, for 
even if you think you do not mind the 
light, nature demands the darkness for 
sleep. 

If possible, the night nurse should 
have a room alone, for if friends room 
together there is always the temptation 
to talk, and conversation destroys all 
inclination to sleep. 

In the afternoon when awaking, un- 
less dinner is to be had at once, the 
nurse should have some hot coffee or 
tea, which will take away that feeling of 
exhaustion so many experience after 
sleeping in the daytime. 

Then is the time to go out in the fresh 
air, and every nurse should do so, re- 
gardless of the weather. A brisk walk 
or drive, followed by dinner, gives her 
a feeling of exhilaration and she will go 
on duty refreshed and ready for any- 
thing. 

And now a word in regard to drugs, 
trional, sulphonal, veronal and all those 
harmless (?) sleeping agents wo use 



238 



THE TRAINED NURSE AND HOSPITAL REVIEW 



with such a free hand in our hospital 
work. 

Avoid them as you would a poison. 
The first dose is fatal; avoid the first 
one. No matter how strong the tempta- 
tion to try it "just this once," don't do 
it. Get relieved from night duty ; in 
fact, resort to any expedient rather than 
induce sleep by such dangerous artificial 
means. I cannot put this matter too 
strongly before nurses, for such a small 
beginning as a sleepless day and a tri- 
onal powder has led to so many fatal 
results. 

We often hear quite spirited discus- 
sions in regard to whether or not a 
nurse may sleep a little even though on 
regular night duty, and by regular night 
duty I mean when a nurse is relieved in 
the daytime to sleep. To me it seems 
as though it might be put in the same 
class as the soldier sleeping at his post. 
In war times the sentry found sleeping 
is court martialed and shot, and while 
perhaps such summary punishment 
would hardly be advisable in the case of 
nurses found asleep, still I think the 
subject is worthy of far more serious 
consideration than it is apt to receive. 

Your patient is ill and wholly depend- 
ent on you. All in authority are asleep, 
you alone keep watch, and often it is a 
matter of life and death that you are 
awake and alert. 

Even if a nurse wakens quickly, the 
brain is not so clear and she cannot act 
as intelligently as she could if she did 



not have that heaviness about her inci- 
dental to sleep. A patient sick enough 
to have a night nurse is entitled to 
liave that nurse awake and ready to give 
her instant attention. A great many pa- 
tients hesitate to call a nurse if they 
think she is asleep, and will do without 
things that would relieve her rather than 
disturb the nurse. It is a great comfort 
for a patient to have the nurse awake 
without the trouble of rousing her, and 
one dear old lady said to me, "I am so 
lonely when my nurse goes to sleep, and 
I really feel jealous to think she can 
sleep and I cannot." 

No, a night nurse should not sleep on 
duty, and I would like to see that printed 
and hung in every sick room and hospi- 
tal ward in the country. 

It may be hard to keep awake when 
the patient is sleeping peacefully and 
there are no duties to occupy your mind, 
but if you have some simple fancy work 
or a bit of plain sewing you will find it 
easier. Once yield to the temptation to 
indulge in "forty winks" and you will 
find each night at the same hour that 
heavy, almost unbearable sensation steal- 
ing over you and your eyes will close 
in spite of desperate efforts to keep them 
open, the only remedy being to move 
about. Each night you will find it 
harder to overcome, and your sleep in 
the day time will be more and more 
broken in proportion to the stolen naps 
at night. 



Information Wanted. 
To the Editor of The Trained Nurse: 

I would like to ask Miss A. P. Harrison, 
who wrote in the August number of The 
Trained Nurse on the subject of "How to 



Feed the Baby and Keep It from Colic," 
whether she has any rules for the dieting of 
the nursing mothers. An answer to this query 
will be esteemed a favor. 

An Interested Enquirer. 



)ome €]cpertencefi of a "ETisittng jBlutfiie 



GRACE MARION PRUB, 



ON December the 14th I was called 
to a case of spinal meningitis, a 
woman 28 years old. On the 9th she 
had been exposed from her nephew, a 
boy of 9 years, who had died. On the 
morning of the 13th she was taken with 
chills, head and back ache and general 
grip symptoms. The next morning a 
doctor was called, and gave her phe- 
nacetine, which reHeved her until that 
evening, when the symptoms returned 
more severely, with nausea and vomit- 
ing. Within an hour she was violently 
delirious. Morphia gr. }i subcutaneous 
was given before there was any relief. 
During the night there were Cheyne- 
Stokes respiration, involuntar}' micturi- 
tion and opisthotonos, also "Kernig's 
Sign." Temperature rose in morning 
to 103, pulse 140, and she had two peri- 
ods of delirium until it was necessary to 
use ether. She was taken to the hospi- 
tal and died that night. 

On the 1 6th Albert, 6 years old, in the 
family where the woman had lived as 
mother's helper, was taken ill in the 
same way. Temperature 103, pulse 134, 
respiration 42. Specialists from Boston 
were called in the morning and the anti- 
meningitis serum from the Rockefeller 
Institute was suggested. That after- 
noon a lumbar puncture was made. Two 
tost tubes of spinal fluid very cloudy 
withdrawn and replaced with 30 c. c. 
of the anti-meningitis scrum. Wound 
closed with nsnal collodion dressing. 
The next day the operation was re- 
peated, but only 1-3 of i test tube of 
sninal fluid would flow out. The 30 c. c. 
of scrum was given. The doctor said it 
was usually given on four successive 



days, but conditions were so favorable 
he thought the two were enough. After 
the second injection the head and back 
ache ceased. The patient sat up in bed 
the ninth day and was out of quarantine 
the fourteenth day. 

1 6th, P. M. — 103, 134, 42. 

17th, A. M.— 98*, 112, 28; P. M.— 
loi, 112, 36; serum given. 

i8th, A. M.— 98*, 112,28; P. M.— 99^ 
112, 28; serum. 

19th, A. M.— 98*, 92,.28; P. M.— 100, 
98, 28. 

20th, A. M.— 98*, 88, 24; P. M.— 998, 
96, 24, 

21 st, A. M.— 98, 80, 20; P. M.— 98^ 
86„ 22. 

Temperature normal after this, both 
A. M. and P. M. 

The 2ist, Raymond, eight years, liv- 
ing across the street, was taken the 
same way. The lumbar puncture wa?. 
done very soon after he was taken ill, 
so the spinal fluid was nearly clear, but 
was found to contain the bacteria on 
examination. There was only one in- 
jection given in this case, as temperature 
and other conditions were so good. 
Both boys had an erythema, the same 
as from antitoxine. Tbe cases were iso- 
lated and the usual precautions for con- 
tagion taken. Both boys are now well 
and in school. 

The doctor who is making a study of 
the disease says the germs arc very short 
lived. That 48 hours exposure to sun 
and air renders them harmless. He be- 
lieves they enter the system through the 
nasal tract. The New York Medical 
Journal recently gave a record of 70 
cases in which the serum was used, with 



240 



THE TRAINED NURSE AND HOSPITAL REVIEW 



no deaths nor bad results. The serum 
cuts short the inflammation process be- 
fore the formation of pus. It is inter- 
esting to note that the serum costs 
nothing. Mr. Rockefeller is making all 
tills possible. 

Another interesting case I had was 
a cephalhematoma of enormous size. It 
was the woman's fifteenth pregnancy, all 
full term ; she had also two miscarriages. 
She was six months pregnant, and as 
large as with twins at term. She had 
been ill nearly all the time, and had 
been in bed for two weeks. Had nag- 



ging pains for several days and then 
labor set in ; examination showed feet 
in vagina and that the mass was not 
twins. Further examination found body 
of six months' foetus with this tre- 
mendous head. Doctor carried a pair 
of scissors past the body up into the 
uterus and punctured the head. I think 
fully a gallon of blood escaped, and the 
delivery was complete. The woman made 
a good recovery. The doctor had three 
or four other such cases, but none so 
large as this. They were all from the 
twelfth to the fifteenth pregnancy. 



Sentence Sermons for the Nurse 

There is only one way to happiness, before you can master those of your 
and that is found by looking for chances fellows. 

^ ■ It is better to be faithful than famous. 



No great things are done by those 
who are unwilling to take pains with 
little things. 



If you cannot stand ridicule you never 
will earn applause. 

You can often lead with the silken 
cord of love when all the cables of logic 
would fail. 



Work is the only master key which 
will open all doors to success. 

If you would lose all force think al- 
ways of your own feelings. 

The truly goodly sec something di- 
vine in everything. 

The more difficult things arc to ac- 



When the wage is the end the work complish the more worth while. 

loses nuich, but the worker loses more. - — — 

Learn to find life's worth in your 

Success is the ability to make step- ^^'^'"'^ "^^^^ ^han in your wage. 

ping stones out of stumbling blocks. 

Sympathy is a key tliat fits the lock 

You must master your own moods (if any heart. 



practical g»uggestton£i for Jlurscfi 



WHEN opening a room just 
fumigated with formaldehyde 
wave a cloth saturated with household 
ammonia in the air. The ammonia 
counteracts the effect of the formalde- 
hyde, which is so very irritating. 



After using permanganate of potash 
and oxalic acid solutions, a solution 
of sterile lime water proves very sooth- 
ing to the hands. 



When a patient is first allowed to take 
a few steps, it is best for him to wear 
high shoes, as the shoes are more sup- 
port than soft slippers, and the tingling 
sensation usually experienced is not 
noticed. 



Poultices can be reheated by steam- 
ing. 



When making a mustard plaster, heat 
an old plate and lay the plaster on it 
for several minutes before using. 

To start water running through an ice 
coil, use a bulb syringe if there is dif- 
ficulty in getting the water started. 



When a patient is unable to have the 
head high enough to use a basin when 
brushing teeth, a soap dish proves very 
convenient. 



When too ill to have the teeth 
brushed, the nurse should get sticks, 
five or six inches long, and wrap the 
ends with cotton and frequently sv»ab 
the mouth with a soothing mouth wash. 



Wlicn the patient is so emaciated that 
the cars have a tendency to become 



sore, make tiny circular pads out of 
horse hair, wrapping them with cheese- 
cloth. 



A hypodermic needle can easily be 
sterlized by boiling in a test tube. To 
sterilize the tablets, dissolve in a spoon 
and boil. For this purpose a candle is 
very convenient. Use an old spoon; it 
can easily be cleaned each time by rub- 
bing with cotton wet with alcohol. To 
clean the needle after using, place the 
point in cotton wet with alcohol and 
draw the piston in and out several times. 
The cotton fibres being wet, do not 
clog the needle and less alcohol is used 
than when drawing it up out of some 
receptacle. 



Gasoline will remove adhesive straps. 



When dressing an abdominal wound 
it is best to put gauze on top of the cot- 
ton, then when the adhesive straps are 
cut for the first dressing, the gauze can 
be cut through the centre and the dress- 
ing underneath be easily removed. When 
the wound is redressed, the adhesive 
straps can be pinned together. 



When an al)dominal wound is dressed 
often and adhesive straps are used, 
fasten them on the hips and turn under 
the free ends far enough so that the 
straps will not adhere to the dressings 
Then cut a hole about one-fourth inch 
from each end. Take a piece of linen 
tape and cut a similar hole in one end. 
Then draw the tape through the adhe- 
sive and through the hole in itself, thus 
tying it. Then tie the tapes together. 
It is then only necessary to remove the 
adhesive when it becomes soiled. 



242 



THE TRAINED NURSE AND HOSPITAL REVIEW 



A sheet or towel twisted tight and 
covered with rubber sheeting will an- 
swer for a Kelly pad. When a Kelly pad 
is used, pin it together at the bottom to 
avoid splashing. 



If silver wire sutures are used for 
an abdominal wound, place gauze under- 
neath them to prevent the skin from be- 
coming irritated. 



In warm weather, if ice cannot be ob- 
tained, try putting the jar of milk in a 
pan of cold water and cover it with a 
cloth, the corners of which should lie 
in the pan. evaporation will keep the 
milk quite cold. 



Collodion will often prevent the for- 
mation of a bed sore. 



Rub sapolio on the window panes 
when preparing for an operation in pri- 
vate homes. 

When rubber tubing is a little too 
small for an irrigation point, try rubbing 
vaseline on the point. If the tubing is 
too large, pinch with haemostatic for- 
ceps. 



A fountain syringe with a sprinkling 
nozzle in the tube can be used in place 
of a shower bath arransrement. 



In an emergency, a roasting p:ui 
with a board over one end, will do for 
a douche pan. 



A straw or goose quill can be used as 
a catheter. One physician not able \n 
get a catheter used a fountain pen filler 
successfullv. 



cradle of two barrel hoops cut in two 
and joined by slats nailed crosswise onto 
them. After stripping the patient place 
this cradle directly over the body and, 
throwing a blanket over this, tuck up the 
patient well up to the neck and around 
the body. Insert into one side of this 
tent the end of a stovepine joint, placing 
under the other end a lighted lamp. The 
air under the tent will soon get so warm 
that the patient will perspire freely in a 
short time. Place a cold compress on 
head of patient, and after a good sweat 
rub off with alcohol as after any sweat 
bath. 



The custom of burning sugar in a sick 
room is very current among all classes in 
France, but up to the present has been 
regarded by scientists as one of those 
harmless and useless practices which arc 
tolerated by the medical profession. But 
M. Trillat, of the Pasteur Institute, states 
that formic aldehyde is given off by burn- 
ing sugar, and is one of the most anti- 
septic gases known. Five grams of sugar 
having been burnt under a ten-litre bell 
glass, the vapor was allowed to cool. 
\'ials containing the bacilli of typhoid, 
tuberculosis, etc., were then introduced. 
Within half an hour every microbe had 
succumbed. 



A novel way of giving a sweat bath 
to a patient too ill to sit up: Make a 



A doctor writes to a medical journal 
on a point that will be of interest to 
nurses. He has noticed that if iodine 
is painted on the human skin in the 
dark, and only a red light such as is 
given by an ordinary photographic lan- 
tern is used, there will be quick al^sorp- 
tion. The skin will be neither discolored 
nor bhstered, even under prolonged use. 
The part painted should be immediately 
covered up, as exposure to any white 
light fixes the iodine in the skin. 



Bream looses 



II. B. rOTIMOIt. 



THE kimono-clad trio in Miss Mor- 
gan's room at the Nurses' Home 
were ostensibly helping her pack her suit 
case in answer to a sudden call, mean- 
while discussing, as is the way of women 
in general, the deflection of one of their 
sisterhood whose wedding cards had 
just been received. 

"I call it downright mean to sneak off 
like that when we are dying to show our 
good will," complained Miss Taylor. 

"She might have had a little more 
consideration for our supersensitive 
nerves. I've hardly recovered from the 
shock," said Miss Von Vimphen. who, 
fat, fair, and unmistakably German, 
didn't look as if she had a nerve in her 
body. 

"You're all jealous," declared little 
Miss Fletcher, dimpling. "There isn't 
one of you that wouldn't jump at a 
chance like that — a young man, rich, 
adoring and handsome. It's sour grapes, 
pure and simple." 

Miss Morgan turned from the mirror, 
jabbing her hatpins fiercely through her 
hat. In six years of nursing she had 
not lost her Puritan convictions, though 
how she had retained them through her 
various experiences and vicissitudes only 
she could tell. 

"I think it's perfectly disgusting," she 
announced. "How any nurse could per- 
mit herself to become so familiar with a 
patient in four short weeks that she 
would marry hiin, is beyond my compre- 
hension. There is the hack now. Much 
obliged, girls. Good bye." 

"She didn't mean it," said little Miss 
Fletcher; "all the same, she'll get into a 
scrape of that kind herself some day, 
and it will serve her right, too." 



A week later came a letter. Part of it 
Miss Fletcher re-read. 

"An interesting case, but ^rd. My 
patient is a delirious typhoid, about 
thirty, the son of wealthy New Yorkers, 
who have sent him West under the mis- 
taken idea that this is the place for a 
dissipated young man to brace up." 

"Doesn't look much as if she would 
fall in love with that proposition," solilo- 
quized little Miss Fletcher, "but then, 
you never can tell." 

******* 

The long, hot afternoon wore on. Miss 
Morgan sponged faithfully, and as faith- 
fully administered nourishment and medi- 
cine whenever her delirious charge could 
be induced to swallow. The eternal vigi- 
lance that is the price of a delirious ty- 
phoid's life had so told upon her that she 
felt the need of more rest than fitful 
snatches of sleep upon the couch in her 
patient's room. She recognized the warn- 
ing lightness of her head, which fore- 
told exhaustion, and resolved to request 
relief when the doctor made his evening 
call, but instead of the doctor there came 
a message from him, so she took up the 
long night watch, not daring to trust the 
inexperienced landlady. 

In the cool of the early dawn her pa- 
tient grew quiet, and slept, and she, glad 
to rest her throbbing head, but conscious 
of the slightest movement of her charge, 
slept also. It was her name, softly spoken, 
that roused her. Her patient was look- 
ing toward her with wide open, sane 
eyes. 

"Have you forgotten, dear?' he asked. 
In her striving after an elusive memory, 
she crossed the room and knelt beside 
the bed, scarcely conscious that she had 



244 



THE TRAINED NURSE AND HOSPITAL REVIEW 



moved. His thin hand drew her head 
down to his pillow, and his fever-burned 
lips touched hers. 

Then she walked in a garden which 
lay, terrace below terrace, at her feet. 
Her gown, of some shimmering material 
glinted in the sunlight. On every side, 
over walls and terraces, and the sombre 
stone mansion itself that towered above 
her. rioted trailing vines and roses of 
incomparable beauty. In the shadows 
of the great oaks romped a boy child, 
quaintly clad. Across the grass strutted 
a peacock, its gorgeous plumage spread. 
The song of birds and the low tinkle 
of fountains filled the air, while the per- 
fume of the roses, heavy, sweet, fell 
about her like a mist. 

But she did not walk alone. He was 
beside her, not as she had known him, 
but in the glory of his strong, young 
manhood, ^nd in some indefinable way 
she understood that this was as it had 
been from the beginning. Himself and 
her, the Paradise of their home, and their 
child-romping on the shadow-checkered 
grass. 



Miss Morgan lifted her head from the 
pillow, and looked long upon him, white 
and wild-eyed, vainly trying to quiet her 
whirling senses. What far-oflf heaven 
had she glimpsed? Was it but the 
fantasy of an overwrought brain, or had 
he, indeed, led her down through the 
ages, home? At last with a little sob, 
she put her lips to his hot forehead, and 
in the late afternoon when the hot sun 
beat upon the roses over the door, she 
closed his eyes, while the heavy, cloying 
sweetness of the blossoms crept in and 
settled about them. 

4c 4c 4i * * * >l< 

"Home again?" said little Miss Flet- 
cher, cheerfully, though shocked beyond 
expression at her friend's white face, and 
the purple shadows under her eyes. 

Miss Morgan was removing her hat- 
pins. 

"Yes," she answered slowly. "I've 
been gone just three weeks, and I've 
fallen in love with my patient. Those 
roses are beautiful, Marion, but will you 
please take them away. I can't bear the 
scent of roses. My patient is dead." 



Esperanto Qrammars Free 



The editor has received the following com- 
munication, which is published for the reason 
that Esperanto, the international auxiliary 
language, appeals strongly to many who have 
the interest of humanity sincerely at heart, 
and especially to those who believe in the 
ultimate victory of peace, brotherhood and 
good-will among mankind. In Europe Espe- 
ranto has already attained immense popularity 
in medical organizations, and the Red Cross So- 
ciety has seriously taken up the propaganda. 

"Dear Sir — Notwithstanding the great 
amount of publicity which has been given to 
Esperanto, the international language, I find 
that at this time not more than one-tenth of 
the people of the United States have even a 



vague idea of its purpose and scope, and per- 
haps not one in a hundred has a reasonably 
definite conception of it. As a sort of coun- 
ter irritant to the irresponsible criticism whicli 
is occasionally circulated by the uninformed, I 
have printed for a free distribution a second 
edition of 100,000 copies of a small primer, 
'Elements of Esperanto,' setting forth the 
grammar, word construction and purpose of 
the language, and will mail a copy to any per- 
son who requests it, sending stamp for post- 
age. Cordially yours, 

"Arthur Baker, 
"Editor Aiiuvika Esperantisto. 
"186 Fortieth street, Chicago, 111." 



CI)e Biet iiitcljen 



ROSE E. GROSVENOR, 
Past Diet Matron, Iowa Soldiers' Home Hospital. 

Fish and Fish Dishes 



A S ordinarily used, the term fish in- 
■^ ^ eludes, besides the fish proper, 
many other water animals, as oysters, 
clams, lobsters, etc. The term "Sea food" 
is often used to cover the whole group, 
or more particularly salt water products 
as distinguished from those of fresh 
water. The division of fish food to be 
treated in this article will be fish proper, 
both fresh and preserved. 

In the matter of composition, fish, as 
a class, belongs to the proteid foods and 
from the standpoint of both nutritive 
value and palatability is, according to a 
recent government investigator, an im- 
portant food product, and as shown by 
his experiments is equal to beef as a 
source of energy in diet. 

The nutritive value of fish depends to 
considerable extent upon its digestibility. 
Available experimental data shows that 
the white-meated varieties are the least 
nutritive and the leaner sorts more easily 
digested than those containing miict ht, 
fresh cod, haddock, trout, pike, etc., 
being more readily digested than 
salmon, shad or mackerel. Therefore, 
the non-fatty varieties should be the 
ones chosen for invalid diet, although 
salted, smoked or dried fish, on account 
of being concentrated by evaporation, 
are richer in nutritive material, pound 
for pound, than fresh fish. The process 
of curing renders them less easy of di- 
gestion. For this reason it is best to 
discard fish thus preserved from the 



diet of the sick unless it be salt cod, 
which may be used occasionally. Canned 
fish, which is in effect cooked fish, is 
said to compare favorably as regards 
composition with the fresh material, but 
as it seems peculiarly suited to the 
growth of micro-organisms when ex- 
posed to the air it should be used im- 
mediately after opening. 

Fish, more than most foods, requires 
careful selection, preparation and thor- 
ough cooking. To be desirable at all 
it must be strictly fresh, well chosen for 
the manner in which it is to be prepared 
and invitingly served. 

As the least particle of putrefaction 
is quite frequently accompanied with the 
formation of ptomaines, great core 
should be taken to use fish only when it 
is in thoroughly good condition. Fish 
which has been frozen, then thawed and 
kept for a time before cooking is es- 
pecially likely to produce ptomaine pois- 
oning. Decomposition is easily recog- 
nized by the bad odor of the fish. In 
general it may be said that fish is unfit 
for food when the eyes are dull and 
sunken, the gills pale red, the body 
limber and the flesh soft. Good, whole- 
some fish, if laid in a pan of water, will 
sink, while those decomposing will float. 
Fish steaks should have firm flesh and 
glittering, clear skin. 

The best fresh water fish sold in the 
interior are the white fish, lake trout, 
lake bass, pike and pickerel, the first 
named being the best and most delicate 



246 



THE TRAINED NURSE AND HOSPITAL REVIEW 



and having tlie least bones. Fresh fish 
are sold in the market either whole or 
dressed, sometimes only the entrails are 
removed, but often when fully dressed 
for cooking the head, fins and less fre- 
quently the bones are removed. Large 
and medium size fish only are suitable 
for boning. In fact, all fish are of finer 
flavor with the bones left in. If it 
should be necessary to dress them at 
home, scale and clean as soon as pro- 
cured, rinse well in cold water, then 
drain, wipe dry and keep cool until 
needed. Fresh fish should never be 
soaked in water except when frozen, 
when they should be placed in ice water 
to thaw, then cooked immediately. Salt 
fish must be soaked over night in plenty 
of water, skin side up, that the salt may 
freely sink to the bottom of the pan. 

In the preparation of fish for the tabic 
the method of cooking which retains the 
most nourishment is broiling, baking 
the next best and boiling and frying the 
poorest of all, steaming being prefer- 
able to boiling. Beside the above meth- 
ods of preparation, excellent fish dishes, 
such as scallops, souffles, croquettes and 
salads may be made of remnants of any 
variety of cooked fish, and are accept- 
able either for entrees or luncheon 
dishes. The best variety to select for 
the different methods of cookery are 'H^ 
follows: For broiling: Lake trout, white 
fish, shad, fresh mackerel, halibut and 
salmon steaks and all small fish. For 
baking: All varieties except the very 
small fish and fish steaks. For boiling 
or steaming : Haddock, black bass, fresh 



cod, white and blue fish. For frying or 
sauteing: Fish steaks and all the small 
fish, such as brook trout, smelt, perch 
and bullheads. The very large fish are 
generally cut into thick steaks of suit- 
able size for broiling or sauteing. The 
medium large are split open down the 
back and broiled in halves, while all 
small fish are broiled without splitting 
by cooking alternately on each side, 
turning often until well done. All the 
varieties given as suitable for broiling 
should be broiled 15 to 20 minutes in 
all except salmon and halibut steaks; 
these broil 12 to 15 minutes, and small 
fish 5 to 10 minutes. 

In baking, allow one hour for salmon, 
bass, halibut and shad. And for white- 
fish, trout and pickerel, one-half to 
three-quarters of an hour. In boiling 
halibut and salmon allow 15 minutes 
per pound. Bass, haddock and cod, 8 
minutes, and in frying or sauteing small 
fish allow 10 to 20 minutes in all Afrer 
properly cooking, the next important 
point is the serving. One of the most 
essential things at this stage is to have 
the fish hot, neatly dished and accompa- 
nied with an appropriate sauce. A few 
of the favorite sauces for serving with 
the white-meated fish are drawn butter, 
cream, egg and parsley .sauce. Acid 
sauces, such as tomato, sauce piquantc 
or sauce tartare. being most acceptable 
with the oily fish, such as salmon, blue- 
fish, mackerel, etc. 

Sliced hard-boiled eggs, lemons, pars- 
ley, cress and olives may be satisfac- 
torily employed as garnishes. 



€&ttortallp ^peafemg 



Why Not Be Consistent? 

The reactionary movement, which 
nurses in general are urged to resist 
with all the vigor they are capable of, is 
in its very essence a protest against so 
much medical instruction and so much 
utterly useless teaching which has been 
forced on nurses while in training. All 
other features of the movement are sec- 
ondary to that one thing. The New 
York Hospital authorities who were 
among the first to rebel, and who are 
giving diligent study to that phase of 
training with a view to its correction, 
assert their willingness to return to a 
three-year course or even to give a four- 
year course, if they can be convinced 
that it is necessary in order to send out 
nurses properly trained. 

That those who are so violently op- 
posing the reactionary movement, or 
the attempt to get nurse training on a 
rational basis, are convinced that there 
are sound reasons for such a protest on 
the part of hospital authorities, physi- 
cians, nurses and others interested, is 
evident. Wliy, then, are they fighting 
it? Consider, for instance, the following 
statement made by a speaker at the 
Richmond convention : "Many a school 
is turning out nurses who do not under- 
stand how to give a dose of castor oil, 
nor how to make an oyster stew, and 
it is not the poor schools altogether, 
either. One thing that has impressed 
itself upon me very strongly is the fact 
that so much of the teaching of our 
schools as is shown by the examination 



papers is along the line of medicine in- 
stead of nursing." And yet, this same 
speaker is urging nurses to resist any 
change in methods. She has reiterated 
precisely the same opinion which has 
been expressed by practically every one 
interested in rational training, and yet 
she cannot speak too bitterly of those 
who voice the same opinions. 

By all means the most significant 
statement (and certainly an eminently 
creditable and sensible one) made at the 
convention referred to was the follow- 
ing : "I feel more and more every year 
that perhaps we have been going ahead 
too fast. * * * I think we might al- 
most have had an insurrection in New 
York if we had not had the advice of 
the Department of Education to guide 
us and keep us balanced and prevent 
our rushing ahead and thinking we were 
going to reform the earth all in two or 
three years." This is a candid admis- 
sion of mistakes made in the past, a 
confession for which all concerned must 
respect the speaker; but why not act hi 
accordance with the spirit of that con- 
fession? Why oppose any attempt to 
slow up, why oppose any change in 
methods after making a public confes- 
sion of mistakes? 

There is no question that the Board 
of Education has had a difficult task 
for the past five years in New York try- 
ing to restrain these people who wanted 
to reform the earth in two or three 
years. Now that the hospital authori- 
ties and pliysicians have come to the 



248 



THE TRAINED NURSE AND HOSPITAL REVIEW 



assistance of the Department of Educa- 
tion we may hope the joint efforts will 
be successful and that training schools 
may land on a safe middle ground. But 
the question is when leaders publicly 
admit that present methods are unsound 
from a nursing standpoint, when they 
publicly confess their mistakes, why do 
they urge nurses to resist every attempt 
at changing the conditions of which they 
complain? Truly, consistency, thou art 
a jewel. 

+ 

Discussion of Dr. Cabot's Paper 

In the March number we presented 
a paper by Dr. Hugh Cabot, "Is the 
Three Years' Course in Training Schools 
for Nurses Unnecessarily Long?" and 
in this number we give the very inter- 
esting discussion which followed the 
reading of the paper. It will be seen 
that with two exceptions the speakers 
were in favor of a two years' course or 
a two years' course with an elective 
third year. As the chairman stated, the 
question of "elective" seems to be a 
compromise between two views. 

It is quite apparent that little head- 
way will be gained toward a unanimous 
opinion regarding the length of course 
until we can reach a unanimous opinion 
as to what shall constitute the course. 
Is it to be a training for the proper 
care of the sick in the hospital and 
home, or a "liberal education"? 

Dr. Cabot calls attention to the frank 
avowal of a superintendent of nurses 
that the modern training school is not 
only training nurses in the ordinary 
sense of the word, but is also preparing 
pupils for other branches of social ser- 
vice, such as health board, factory and 
bakeshop inspection, charity organiza- 
tion work, etc. 



We agree fully with the following per- 
tinent statement: 'Tn any case, it seems 
to me that training schools for nurses 
should no longer be spoken of as such, 
if it is their avowed purpose to train 
women for very much broader fields. 
If they no longer devote their time to 
training of nurses, this fact should be 
clearly stated in the prospectus, and 
those hospitals which do confine them- 
selves to trauiing women for the care 
of the sick should not be criticized be- 
cause they do not go beyond their 
avowed purpose." 

During the course of the discussion 
of Dr. Cabot's paper the question arose 
as to why the New York Hospital went 
back to the two years' course. As there 
seems to be considerable misunderstand- 
ing on the subject, we believe it is op- 
portune to present the reasons as set 
forth by Dr. Samuel W. Lambert in the 
"Alumnae News." These will be found 
in the Letter-Box of this issue. 
+ 
Some Recent Decisions 

In the March number we called atten- 
tion to the rather premature rejoicing in 
certain quarters over the presumed set- 
tling of the vexed question of the length 
of training school course. We also pre- 
dicted that the Visiting Committee's 
report, however interesting, would not 
carry with it great weight, for reasons 
which we stated. In verification of our 
prediction, Commissioner Robert W. 
Hebberd of the Department of Public 
Charities, New York City, in spite of 
the report, has re-established the two 
years' term in the Kings County and New 
York City training schools for nurses 
under his jurisdiction. 

Another interesting fact bearing upon 
this subject is that the Board of Direct- 
ors of the training school recently estab- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



249 



lished in connection with the University 
of Cahfornia Hospital has decided on a 
two years' course, with a third year as 
post graduate. It has also decided not 
to set the usual age Hmit for appHcants, 
but will take them as young as eighteen 
years, letting the decision rest on the 
•personal fitness of the applicant. There 
will also be three nurse representatives 
on the Advisory Board of the training 
school. 

In our opinion these decisions are 
wise ones. While we have favored the 
shortening of the regular course, we 
have always advocated post graduate 
work or an optional course. In regard 
to setting an age limit for applicants for 
the training school, many years ago Dr. 
Weir Mitchell pointed out that many 
valuable women were lost to the pro- 
fession by the rigid adherence to a set 
of fixed rules rather than a considera- 
tion of the personal qualifications of the 
candidate, and more recently a writer 
in the National Hospital Record has 
pointed out the undesirability of draw- 
ing the lines too tight in this regard, 
and has raised the question as to wheth- 
er the age hmit might not be one of the 
factors in the waning nurse supply. 

From the decisions quoted it would 
seem that the so-called "retrograde 
movemeni" had been in no wise checked, 
but rather given more impetus. 

+ 
The Male Nurse 

The letter from Mr. Boothby in the 
Letter-Box of this number brings to 
mind some opinions regarding male 
nurses as expressed by those who had 
gained their experience as teachers in 
training schools for male nurses. The 
quotations are taken from personal let- 
ters and are as follows : "My experi- 



ence with the men nurses gives me an 
excellent opinion of them; some are fine 
men as well as devoted nurses, and I was 
astonished to find that sentiment had 
led many of" them into the work. Of 
course they do not work exactly as the 
women do, but as a class I think they 
are not appreciated." 

Another letter says : "I saw in the 
Journal the other day the statement: 
'There are no nurses but women.' I 
beg to differ, having seen men who were 
devoted nurses and more tender than 
the average woman." It must be under- 
stood that these tributes to the male 
nurse come from women nurses, and we 
take pleasure in publishing them. While 
it is undoubtedly true that the great 
bulk of nursing the sick must devolve 
on women, still, as Mr. Boothby points 
out, there are cases and occasions when 
the mal^ nurse seems absolutely indis- 
pensable. 

+ 
Miss Hudson's Paper 

The ideas expressed by Miss Hudson 
in her paper on State Registration in 
this number are on the same broad 
lines as those expressed some years ago 
by Miss Sylveen V. Nye of Buflfalo, but 
with the added value of the actual work- 
ing experience of registration laws, 
which Miss Hudson has gained as a 
member of the State Board of Nurse 
Examiners. 

We may not all agree with Miss Hud- 
son in regard to the very long prelimi- 
nary preparation nor as to the A. B. 
degree and other minor points, but all 
must admit that this is one of the most 
thoughtful, most carefully worked out 
and well expressed articles on nursing 
matters which have yet appeared. 

Not the least of its value is the 
bringing into the "limelight" of the 



250 



THE TRAINED NURSE AND HOSPITAL REVIEW 



misuse of the R. N., which has been the 
subject of so much adverse criticism out- 
side the profession. When we consider 
that this same R. N. is in no possible^ 
sense a degree, the tacking it onto one's 
name at all times and on all occasions 
shows little appreciation of the fitness of 
things. This very forceful presentation 
is rendered all the more so by the fact 
that Miss Hudson is not only an R. N., 
but also has a real degree of A. M., 
which she modestly refrains from using. 
We commend Miss Hudson's paper to 
all those interested in State Registra- 
tion for Nurses. 

+ 
Hard to Decide 
We find ourselves in a rather difficult 
position in regard to the suggested 
change in The Trained Nurse. At first 
the nurses who wished the Nursing 
World Department cut down were far 
in excess of those who wished it kept 
to the present number of pages, but 



as time went on the other side gained, 
and at present writing the opinions are 
about evenly divided. The following 
letters will serve as specimens repre- 
senting each side. 

"Dear Editor — Please cut down the 
'Nursing W^orld' as much as possible and 
give us private duty nurses something 
more helpful. I always come to The 
Trained Nurse for my inspiration and 
help, and it never fails me, but please 
give us more of it. Yours, 

"Dora Battson." 

"Dear Editor — Please keep The 
Trained Nurse as it is. Don't cut down 
the 'Nursing World.' It is often the 
only way we ever hear of old friends. 

"E. M. SWAINSON." 

One subscriber has suggested that we 
increase our number of pages and there- 
by sacrifice nothing. This is no doubt a 
happy solution, and would be quite pos- 
sible if each subscriber who wishes this 
would send us just one new subscriber. 



News From Illinois Wanted. 
To the Editor of The Trained Nurse: 

I was glad to see in the December number 
Lctter-Box a list of questions asked by "An 
Often Perplexed Nurse." They are exactly 
what I have wanted to ask. 

I am also much interested in the articles on 
the question of fees, and how the patient of 
moderate means is to be cared for. It is a 
problem here in our small city, where we have 
two good general hospitals and three private 
ones. One thing I have not found is some- 
thing about the Illinois State Association. I 
do not know what is being done by our State. 
Will some one please inform me through 
The Trained Nurse? 

An Illinois Nurse. 



Testimonial. 
To the Editor of the Trained Nurse: 

The Trained Nurse is a fine magazine, and 
personally do not think that I could give it up 
for any other. My opinion would be to cut 
down the Nursing World news and to devote 
the space thus gained to practical articles, 
for that is what the private duty nurse needs. 
I have found your practical articles very 
helpful. 

In regard to the nurses' fee, think we 
should have a stated or standard price. My 
experience has been that those in moderate 
circumstances paid the nurse's fee more will- 
ingly than some of their wealthy neighbors. 
Very truly, 

L. WiNFIELD. 



M tfie Jturstng Woxlo 

ARTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATURE OR NOT, ARE CONTRIBUTED, AND 
DO NOT NECESSARILY REPRESENT THE IDEAS OR POLICY OF THIS MAGAZINE. 



Indiana State Association. 

A meeting of the Indiana State Nurses' As- 
sociation will be held at Fort Wayne, March 
27 and 28. The speaker of the occasion will 
be Miss Isabel Mclsaac, whose subject will be 
"What Work Do the State Societies Do After 
Registration Has Been Secured. 

+ 
Los Angeles County Nurses' Association. 

The Los Angeles County Nurses' Associa- 
tion held a regular meeting Tuesday, February 
II. Miss Wheeler, daughter of the late Gen- 
eral Joseph E. Wheeler, was the guest of 
honor. Miss Wheeler related some of her ex- 
periences during the Spanish-American war. 
The following papers were read : "Venereal 
Diseases ; Cause and Danger," "Gonorrheal 
Ophthalmia." 

+ 
Louisiana State Nurses' Association. 

The fourth annual meeting of the Louis- 
iana State Nurses' Association was held 
February 22 at the New Orleans College of 
Dentistry. The following officers were elected : 
President, Miss Fromherz, of the Touro 
Training School; first vice-president, Mrs. L. 
Breaux, of New Orleans Sanitarium; second 
vice-president. Miss Lillian Hewitt, of the 
Charity Hospital; secretary, Miss M. H. Minis, 
of the New Orleans Sanitarium; treasurer. 
Miss Seddon, of the Charity Hospital. New 
members elected were Miss Tisdale and Miss 
Mclancon, of New Orleans Sanitarium ; Miss 
E. M. Weathers, of Garfield Memorial Hos- 
pital; Miss E. C. Criswell, of Chicago Baptist 
Hospital ; Miss M. E. Hardie and Miss 
Fritsch, of Hotel Dieu. 

+ 
Michigan State Nurses' Association. 

The sum (if $560 lias bci'ii sent lo the Asso- 
ciated Alunmae by the Michigan State Nurses' 
Association, its contrihiUion to the Hospital 
Economics Fund, 



This was sent as a memorial to Miss Mary 
Smith, a charter member, ^ho died at Harper 
Hospital of pneumonia, contracted while nurs- 
ing a patient. A part of this sum was given 
by her family as a special memorial. 

Miss Smith was a graduate of the Farrand 
Training School, Detroit, and was the one 
who started the work of raising funds for this 
purpose in our State. It was largely due to 
her untiring efforts that we are able to send 
this money. 

+ 
District of Columbia. 
The Nurses' Examining Board of the Dis- 
trict of Columbia will hold examination of 
applicants for registration April 30, 1908, at 
Garfield Hospital. All applications must be 
filed with the secretary of the board by April 
15, 1908. 

+ 
The Associated Alumnae. 

The eleventh annual meeting of the Nurses' 
Associated Alumnae will be held in 'San Fran- 
cisco, Cal., May 5 to 8. The meetings will be 
held in Golden Gate Hall, on Sutter street, 
and the headquarters will be the St. Francis 
Hotel. 

Some of the topics to be presented are : 
"The Nurse in Preventive Medicine," "The 
Nurse in the Public Schools," "Children's 
Clinics," "Tuberculosis," "The Curriculum," 
"Nursing the Insane as Part of a Three Years' 
Course," "Home Life of the Pupil Nurse," 
"Clubhouses and Registries," "The Question 
of Nurses' Charges," "The Responsibilities of 
the Private Duty Nurse in the Associations." 

The Inter-State Secretary's report will be 
heard on the last day; also papers on "Prog- 
ress of Registration in Foreign Lands," "ihe 
Effect of Registration in the Profession and 
on the Individual," "Difficulties of Examining 
Boards" and "Work of the State Associations 
After Registration Has Been Secured." 



252 



THE TRAINED NURSE AND HOSPITAL REVIEW 



The California nurses are using every ef- 
fort to make this convention one of the most 
notable in the history of the association. 
+ 
Superintendents of Training iSchools 
for Nurses. 

The fourteenth annual convention of the 
Society of Superintendents of Training 
Schools for Nurses will be held in Cincinnati, 
Ohio, April 22, 23 and 24. 

+ 
Spanish-American War Nurses. 

The ninth annual meeting of the Spanish- 
American War Nurses' Association will be 
held in Chicago, 111., June 4, 5, and 6, 1908. 

An earnest appeal is being made by the 
society to have all members become life mem- 
bers, and also to have members attend the 
meeting in Chicago, as it will be an important 
meeting, and their support is needed to act 
on new legislation for the society. 

Will members kindly signify their prefer- 
ence for a place for holding the annual meet- 
ing in 1909? Seattle, Wash.; Philadelphia, 
Pa., and New York City have been mentioned. 
Yours very respectfully, 

Amanda A. Ludlow, 
President S. A. W. N. Association. 
Rebecca Jackson, 
Fort Hamilton, N. Y., Treasurer-Cor. Sec, 
March 9, 1908. Overbrook, Pa. 

+ 
Camp Nicolas Senn. 

The regular meeting of the camp was held 
on Tuesday, March 3, and after routine busi- 
ness had been disposed of a talk ensued rela- 
tive to the best way of entertaining the guests 
who shall be present at the annual meeting of 
S. A. W. N., to be held in Chicago, June 4, 
5. 6. . 

Mrs. Mintcer, who is leaving the city, ten- 
dered her resignation as secretary-treasurer 
of the camp. 

The next regular meeting will be held on 
Tuesday, June 2, at 2:30 p. m., in Mandel's 
Ivory Tea Room. 

+ 
Camp Roosevelt. 

The annual meeting of Conip Roosevelt 
was held on March 2, .at No. 596 Lexington 
avenue. The officers elected for the ensuing 
year were: Chairman, Mrs. James W. Tay- 
lor; vice-chairman, Miss Anna M. Charlton; 



secretary-treasurer. Miss Alice P. Lyon. Mrs. 
Henry Hunt Ludlow, president Spanish- 
American War Nurses' Association, was en- 
dorsed by members present as a candidate for 
re-election at the next annual meeting of the 
National Association. 

The next meeting of Camp Roosevelt will 
be held on Wednesday, April i, from 3 to 6, 
at the home of Miss M. E. Tuttle, No. i Park 
avenue, Yonkers, N. Y. 

Alice P. Lyon, 
Secretary Camp Roosevelt. 

+ 
Pittston, Pa. 

There was a large attendance at the gradu- 
ating exercises of the class of 1908 of the 
Nurses' Training School of the Pittston (Pa.) 
Hospital. The exercises were held in the First 
Presbyterian Church. 

S. B. Bennett, president of the Board of 
Trustees, presided, and in his introductory re- 
marks referred to the work that has been done 
and is now being done at the hospital. From 
November i, 1893, to the present more than 
4,000 patients have occupied beds in the hos- 
pital, and there have been more than 17,000 
treatments, medical and surgical, in the dis- 
pensary. During 1907, the fatal results of tlic 
Pittston Hospital were only 8 per cent., and of 
these 4 per cent, died within twenty-four hours 
after admission. A word in regard to the per- 
centage of foreign cases — a matter frequently 
commented on. Of the 343 cases adniittid 
during last year 38 in 100 were born in tlic- 
United States, 9 in 100 in Great Britain and 
from Continental Europe 53 in 100. So that 
47 per cent, of the patients were Englisli 
speaking people and 53 per cent. Polish, Ital- 
ians, etc. When it is considered that at least 
70 out of each 100 of our mine workers arc 
natives of Continental Europe, it is quite re- 
markable that but 53 per cent, of the hospital 
cases are furnished by them. 

The address to the nurses was delivered by 
Dr. P. F. Gunster, a prominent Scranton phy- 
sician, and was replete with advice and en- 
couragement for the young ladies who were 
about to enter on the practice of their pro- 
fession. 

The Hon. W. G. Gillespie, Mayor of Pitts- 
ton, made a brilliant address on the modern 
hospital and its mission of mercy. 

The graduates are Gertrude Beatrice Miller, 



THE TRAINED NURSE AND HOSPITAL REVIEW 



253 



Onor Olive Oblinger and Elizabeth Cecelia 
Hunt. 

A pleasing feature was the presentation of 
the diplomas to the young ladies of the gradu- 
ating class. Mr. Bennett made the presenta- 
tion on behalf of the Board of Trustees in a 
brief address, in which he said that the di- 
ploma was not only a certificate of the trus- 
tees' confidence in the graduate, but a legal 
warrant empowering her to pursue her chosen 
profession. Mr. Bennett also presented to 
each of the young ladies, with the compli- 
ments of the trustees, the emblem adopted by 
the Nurses' Training School — an enamelled 
cross, surrounded by a suitable inscription. 
Each pin, as it was presented, was accompanied 
by a bouquet of beautiful roses. 

The exercises were brought to a close with 
the benediction by Rev. R. A. Rinker. 
+ 
Colorado Springs. 

At the monthly meeting of the Colorado 
Springs Registry Association, held on March 
4, a very interesting address on "New Avenues 
of Work for Nurses" was given by Miss L. 
A. Beecroft, Pueblo's newly appointed mem- 
ber on the State Board of Nurse Examiners. 



The graduates are Miss Nora Cotter, Ten- 
nessee; Miss Elizabeth Busman, Indiana; Miss 
Annie G. Porter, North Carolina; Miss Ethel 
Kirkland, Kentucky; Miss A. Murphy, Ten- 
nessee; Miss Clara >Coomes, Kentucky; Miss 
M. Steinwand, Minnesota; Miss Estelle Eb- 
binghaus, Tennessee. After the presentation 
of the diplomas a 6 o'clock dinner was served 
to the entire school. 

+ 
Savannah, Ga. 

The Alumnae Association Park View Sani- 
tarium, Savannah, Ga., meetings in February 
were well attended, there being more nurses 
present than at any other time. 

The election of officers for the year resulted 
as follows : President, Mrs. M. S. Morel ; vice- 
president. Miss C. A. Mathiack; secretary and 
treasurer, Mrs. E. C. Westcott; chairman ar- 
rangements committee. Miss H. Schwalbe. 

The social meeting held the third Thursday 
was an exceptionally pleasant one. Several in- 
teresting papers were read on "Our Associa- 
tion," "Our Aim" and "Unusual Case in a 
Nurse's Experience," followed by a very in- 
teresting talk by Dr. J. L. Hiers. 

Refreshments followed. 



Indianapolis, Ind. 

The graduating exercises of the Indianapolis 
City Hospital Training School for Nurses 
were held in Clinic Hall, at the hospital, at 
8 p. m. February 6. 

The hall was beautifully decorated in the 
class colors, lavender and white, as was also 
tlie nurses' home, where, after the exercises in 
the hall, a reception was held. 

Hart's full orchestra furnished the music 
fur the evening. 

Refreshments were served by the members 
of the junior and freshmen classes. 

There were eleven graduates — Miss Martha 
Evans Smith, Miss Viola Cox Smith, Miss 
Artie Elizabeth Fisher, Miss Mary Blanche 
Mcllwainc, Miss Anna May Gant, Miss Mary 
Elizabeth Davis, Miss Lucy May High, Miss 
Ikrtha Jane Pember, Miss Blanche Elizabeth 
N'eff, Miss Lela Randolph Davis, Miss Ger- 
trude Glicea Medlin. 

+ 
Nashville, Tenn. 

The graduating exercises of the St. Thomas 
Hospital Training School for Nur.scs were 
held Wednesday evening, February I2, 1908. 



Somerville, Mass. 

The Somerville Hospital Nurses' Alumnae 
Association held its annual meeting and a re- 
ception in the parlors of the Y, M. C. A. 
Building, on Highland avenue, Wednesday 
evening, February 12. 

The nurses were honored by the presence 
of several of the trustees, as well as Mayor 
Grimmons, who is also a trustee. The asso- 
ciation also entertained. Miss Hogel the su- 
perintendent, Miss Irving, er assistant, and 
the pupil nurses of the hospital. 

The following officers were elected : Miss 
Annie Taylor was re-elected president; Mrs. 
Annie M. Snow, first vice-president ; Miss Vir- 
ginia Crommetti, second vice-president; Mrs. 
Bona S. Chillis, secretary; Mrs. M. L. Alger 
was re-elected treasurer, and Miss Eva A. Mc- 
Bride, sub-secretary. There were seven new 
applications presented for r.iembership. Much 
enthusiasm is shown in the sick fund, which 
has been recently started, and there was a 
great deal of discussion as to ways and means 
to swell this fund, which is very small at pres- 
ent. 

At the close of the business meeting the offi- 



254 



THE TRAINED NURSE AND HOSPITAL REVIEW 



ccrs received, while Mrs. Snow, Mrs. Nicholas 
and Miss Crommetti acted as ushers. A long 
table in the back parlor was very prettily dec- 
orated with flowers, at which Mrs. J. M. Scott 
and Mrs. C. Nellis poured and served refresh- 
ments. The Misses Trueman orchestra ren- 
dered very pretty music -during the evening. 
All seemed to have had a joyous time. 

+ 
Fall River, Mass. 

The regular monthly meeting of the Nurses' 
Alumnae Association was held on March 4, 
1908. 

Mrs. George L. Richards read several selec- 
tions, which were much enjoyed, after which 
light refreshments were served and a social 
half hour followed. 

There was a good attendance and the regu- 
lar business meeting was held. A new treas- 
urer was elected, the one elected the first of 
the year not being able to serve. 

Laura W. Wood, 
Corresponding Secretary. 

+ 
Albany, N. Y. 
The ninth edition of the Albany Nurses* 
Directory is just out, with the names of 159 
graduated nurses, twenty-three more than was 
listed last year. Only five of this number are 
male nurses. 



Number of Visits 17.445 

Disbursements $8,698.47 



At the March meeting of the Albany Guild 
for the Care of the Sick, routine business was 
transacted and the reports of the various com- 
mittees acted upon. The nursing work of the 
Guild shows no decrease, the nurses having 
made 1.797 visits during the month of Febru- 
ary. There were 239 cases and thirteen nurses 
were on duty. 

A file of reports dating from 1890, when a 
one-page leaflet was sufficient to give a sum- 
mary of the year's work to the last annual 
report with its seventy-eight pages, makes in- 
teresting reading. 

The following figures speak for themselves : 
1890. 

Number of Nurses i 

Number of Patients 116 

Number of Visits 1,146 

Disbursements $567.06 

1907. 

Number of Nurses II 

Number of Patients 1,426 



The sixth term of the Albany School for 
Nurses, conducted at No. 7 Hight street, by the 
Eastern New York School for Certified 
Nurses, opened the third week in February. 
This school is proving very successful in its 
work and has met with the approval not only 
of our citizens generally, but has also received 
the endorsement of the Committee on Train- 
ing Schools of the New York State Medical 
Society, which represents probably 85 per cent 
of the physicians of the State. A large num- 
ber of Albany physicians are down for lectures 
for the coming year. 



At the last graduation exercises seven 
young women received diplomas as trained 
nurses. They are: Miss Ellen Daly, Mrs. 
Louise P. Leo, Mrs. Lillian Mochrie, Miss 
Anna Tinchin, Mrs. Margaret Rosencrans, 
Mrs. L. Scott, Mrs. Tomasason. 

The work of the school is supervised by 
Miss Edith Rice, R. N., a graduate of the 
Clifton Springs Sanitarium Training School, 
and Miss Louise Noeckel and their assistants. 



At the annual meeting of the State Board 
of Regents, held recently, Mrs. C. N. Simp- 
son, superintendent of the Albany Hospital 
Training School for Nurses, was appointed 
to the advisory council of nurses' training 
schools. 



A linen shower was given Miss Killough at 
tlic Nurses' Alumnae Club, No. 351 Hudson 
avenue, in honor of her then approaching 
marriage to Dr. Bennett Garlick. 



On Monday evening, February 24, 1908, the 
Presbyterian Church, Menauds, was the scene 
of a very pretty wedding, when Miss Mar- 
garet Esther Killough, daughter of Mrs. 
Katherine Killough, of Menauds, was married 
to Dr. Joseph Bennett Garlick, of Albany. 
Rev. Mr. Phillips officiated. The church was 
beautifully decorated with palms and flowers. 
The ushers were Dr. Hoffman, of Glen Falls ; 
Harry Jackson, Schenectady; Newton B. 
Arthur, New York, and Frank Tryst, of 
Schenectady. The best man was Mr. Ray 
Stern, of Schenectady. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



255 



The bride, who is a graduate of the Albany 
Hospital Training School for Nurses, wore a 
liandsome empire gown of white messaline, 
trimmed with princess and filet lace, and car- 
ried a shower bouquet of white sweet peas. 

The maid of honor, Miss Edna May Van 
Zandt, wore a dainty gown of pink mousse- 
line and carried a bouquet of pink sweet peas. 

A wedding reception followed the cere- 
mony, after which Dr. Garlick and his bride 
left for a Southern trip. The groom's gift to 
his bride is a gold necklace, and the bride's 
gift to her attendant is a pearl pendant and 
gold chain. 

At home at No. 1019 State street, Schenec- 
tady. 

After years of service as nurse in the State 
Hospital for the Insane, at Middletown, Mrs. 
Jennie M. Dunvan died in harness recently. 
She was an Albanian. 



The Training School for Nurses of the Al- 
bany Homeopathic Hospital has received from 
Troop B $300, being one-half the proceeds of 
the entertainment given a short time ago. 



Dr. Lempe gave an interesting lecture on 
"Emergencies" to the Alumni of the Albany 
Hospital Training School at the club house 
on Wednesday afternoon. 



Miss Cecilia P. Templeton, formerly of Al- 
bany and connected with the Albany City 
Hospital, has gone to St. Louis, where she 
has been made assistant pastor of the First 
Congregational Church. 



Miss Katherine Langford, a nurse at the 
Albany Hospital, has been ill of scarlet fever. 
+ 
Buffalo, N. Y. 

The March meeting of the Buffalo Nurses' 
Association was devoted to a discussion of 
ways and means to increase the Club House 
Fund. Several plans were proposed and it 
was decided to defer action until the June 
meeting, when arrangements for work will 
be more presentable. Mrs. Harriet Dorr 
Storck, Miss Nellie Smith and Miss Hannah 
Dwyer were appointed a committee to ascer- 
tain prices of real estate and to secure op- 
tions on buildings suitable for a club house. 

Miss Edna Abbey, Miss Marie Louise Gag- 



non and Miss Florence Tebstock were elected 
to membership. 

A pleasant feature of the afternoon was 
the singing of Mrs, W. I. Sackett, accompa- 
nied by Miss Daisy Small, 

By a unanimous vote the members decided 
to forego the annual banquet and give the 
money which would thus be used to the Dis- 
trict Nursing Association to aid in the work 
of caring for the sick poor of the city. 

This was especially generous, as the asso- 
ciation had already contributed to this fund, 
but the destitution of the city and the pathetic 
stories of the district nurses touched the 
hearts of all who heard them and a generous 
contribution was the result. 

Mrs. Henry Altman has been chosen an 
honorary member of the Buffalo Nurses* As- 
sociation in recognition of her work in secur- 
ing medical inspection in the public schools 
of the city, Mrs. Altman has long been inter- 
ested in the association, and the members wel- 
come her with pleasure and with pride. 
+ 
New York City. 

The monthly meeting of the Alumnae Asso- 
ciation of the New York City Training School 
for Nurses was held on Tuesday, March 10, at 
the Academy of Medicine, from 3 to 6 P. M., 
Miss Pindell in the chair. The illness of Miss 
Lay and Miss Muldoon was reported. After 
the regular routine of business the "Question 
Box" was brought forth and its contents dis- 
cussed. The conclusion that might be drawn 
from the tone of the "questions" was that the 
members of this association wanted affiliation 
with all the big societies and a "dance" as 
soon after Easter as possible. Refreshments 
were, as usual, served in the banquet hall, pre- 
sided over by Miss Abrams, assisted by her 
mother. 

Florence M. Kelly, Cor, Sec'y. 

420 West iT6th street. 

Philadelphia, Pa. 

The regular stated meeting of the Nurses' 

Alumnae Association of the Mcdico-Cliirurgi- 

cal Hospital was held on March 5 with a very 

good attendance. 

The meeting was short but very interesting. 

After the business was transacted a social 

time ensued and Miss V. V. Kahler served tea. 

Mrs. Phaon J. Rex, 

Secretary. 



256 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Married. 
Married, March 3, 1908, Miss E. L. Moore- 
house, graduate of class '05, West Side Hos- 
pital, Chicago, 111., to Ernest J. Ford, M. D., 
1904 Central street, Evanston, 111. 

+ 
Birth. 

Born, in Elwood, Ind., to Dr. and Mrs. C. C. 
Cotton, a son. Mrs. Cotton was Miss Stella 
Everinghaus, class 1894, Jewish Hospital, Phil- 
adelphia, Pa. 

+ 
Personal. 

Miss Minnie Lycan, who has been in charge 
of the operating room of Dr. Holmes' Hos- 
pital, Cincinnati, has resigned and will go to 
the City Hospital, Springfield, Ohio, as as- 
sistant superintendent. 



Miss Alice E. Traub, of Philadelphia, has 
been appointed missionary nurse by the Re- 
formed Church of America. She will serve as 
chief nurse in the hospital just erected in the 
Hunan Province, China. Miss Traub is a 
graduate of the Hahnemann Hospital. 



Miss Clara W. Dyring, the first superintend- 
ent of Hackley Hospital, Muskegon, Mich., 
will go to Turkey to establish a hospital in 
connection with an Oriental college at Mar- 
sovan. 



Miss Mabel Craft, superintendent of the 
Cottage State Hospital, Connellsville, Pa., pre- 
sented her resignation at the annual meeting 
of the Board of Trustees. The resignation 
was accepted, and Miss Katherine Zeiser was 
appointed to succeed her as superintendent. 

Miss Craft's resignation was prompted by 
the invalidism of her mother, who requires her 
attention and care. In accepting her resigna- 
tion the directors passed the following resolu- 
tion: 

Resolved, That the board accepts the resig- 
nation of Miss Craft with sincere regret, hav- 
ing a grateful appreciation of her efficient ser- 
vices during the past two and a half years. 

Resolved, That a copy of this minute be en- 
grossed by the secretary and presented to Miss 
Craft with the good wishes of the trustees. 



Miss Anna M. Rindlaub, connected with the 
training school for nurses, and also a member 



of the Board of Directors, will succeed Super- 
intendent F. A. Creamer as temporary head of 
the South Side Hospital, Pittsburg, Pa. 



Miss Eleanor Keister has been appointed 
acting superintendent of day nurses at City 
Hospital, Worcester, Mass., and it is expected 
that the hospital trustees will elect her to be 
permanent superintendent of the entire force 
of nurses. Miss Clara May Thurston, of Au- 
gusta, Me., has been appointed acting assistant 
superintendent of nurses to succeed Miss Keis- 
ter. 



Miss Susie Hovey, graduate of Wesley Hos- 
pital, Chicago, 1902, is making a rapid recov- 
ery from a serious abdominal operation, per- 
formed February 13, at the Harrison Chappie 
Hospital, Chanutc, Kan. 



Miss Mary C. Maguire has returned to her 
home in Hopkinsville, Ky., after spending six 
months with a patient in California, Mexico 
and Texas. 



Miss Ruth E. Mason, of Philadelphia, has 
been engaged by the Delaware Anti-Tubercu- 
losis Society to take charge of the dispensary 
and the work in connection with that institu- 
tion at Wilmington. 



Miss A. K, Bitner, who has been superin- 
tendent of nurses at Hoffman Hospital, Key- 
ser, W. Va., for quite a while, has resigned to 
accept a position in the Garretson Hospital, 
Philadelphia. Her successor has not yet been 
appointed. 



Miss Hattie Grant has been appointed as- 
sistant chief nurse of the State General Hos- 
pital, at Rock Springs, Wyoming. 



Mrs. E. M. Swainson has resigned her posi- 
tion as matron of the Silver Cross Home, 
Maryland, and will join a friend in Vincland, 
N. J., to care for consumptive children. 



Mrs. Florence K. Gray, of Portland, Me., a 
graduate of the New York Infirmary for 
Women, and also a graduate in the Swedish 
system of massage, medical and orthopaedic 
gymnastics, electro- and hydro-therapy at 
the Pennsylvania Orthopaedic Institute and 



THE TRAINED NURSE AND HOSPITAL REVIEW 



257 



School of Mechano-Therapy, Philadelphia, Pa., 
has been engaged by the Columbus State Hos- 
pital, Columbus, Ohio, to take charge of the 
mechanical department as well as to instruct 
the nurses in the before-mentioned branches 
of mechano-therapy. 



IMiss Margaret Farrell has been transferred 
from the Wyoming General Hospital at Sheri- 
dan, Wyo., to Rock Springs Wyoming General 
Irlospital. Mi^s Farrell has been in Sheridan 
for the past nine months, and has won the 
respect and admiration of the people of Sher- 
idan, and received a flattering endorsement 
from the Sheridan County Medical Associa- 
tion. Miss Farrell is a graduate of the Wy- 
oming General Hospital at Rock Springs, and 
took a post-graduate course at the Presbyterian 
Hospital in Chicago. Miss Converse has been 
chief nurse at Rock Springs for the past three 
years. 



Miss Georgia Glidden, Miss Weed, Miss 
Chamberlain and Mrs. Agnes Kane, 1907 grad- 
uates of the Wyoming General Hospital at 
Sheridan, are doing private nursing in Sheri- 
dan and are kept pretty busy. Miss Fennell 
and Miss Delia Christoff have taken up private 
duty near Cody, Wyo. 



Among the " students taking the Winter 
courses in massage, medical and orthopaedic 
gymnastics, electro and hydro-therapy at the 
Pennsylvania Orthopaedic Institute and School 
of Mechano-Therapy, Philadelphia, Pa., are 
the following trained nurses : 

Miss E. Charlien Talbot, Terre Haute, Ind., 
graduate and assistant superintendent Union 
Hospital, Terre Haute, Ind. 

Miss Nana Henderson, Terre Haute, Ind., 
graduate Union Hospital, Terre Haute, Ind. 

Miss Grace A. Palmer, Plainfield, N. J., 
graduate Muhlenberg Hospital, Plainfield, N.J. 

Miss Mary A. Hagan, San Francisco, Cal., 
head night nurse Southern California State 
Hospital. 

Miss Margaret A. MacBride, Montreal, Can- 
ada, graduate Mary Fletcher Hospital, Bur- 
lington, Vt., member Canadian Nurses' Asso- 
ciation. 

Miss Effa Griffin, Oakland, Cal., graduate 
National Temperance Hospital, Chicago, 111. 

Miss Hanora T. Kelly, Fremont, Neb., grad- 
uate Fremont Hospital. 



Miss Nora A. Thorpe, Nebraska City, Neb., 
graduate Memorial Hospital, Worcester, Mass. 

Miss Katherine Rehsteincr, Evansville, Ind., 
graduate Crescent Sanitarium, Evansville, Ind. 

Miss Jennie M. Malcolm, Bright, Ontario, 
Canada, graduate and assistant superintendent 
Paterson General Hospital, Patcrson, N. J. 

Miss Mary Josephine McCloud, Norwich, 
Conn., graduate New Haven (Conn.) Train- 
ing School for Nurses, superintendent of Ma- 
tanzas Hespital, Cuba, and General Hospital, 
Mexico City; member Spanish-American War 
Nurses' Association. 

Miss Hannah Stroem, Butte, Mont., grad- 
uate Fredericksburg Hospital, Copenhagen, 
Denmark, and Illinois Training School for 
Nurses, Chicago; matron of Murray's and 
Boston and Montana Employee's Hospital, 
Butte, Mont. 

Obituary. 

We regret to announce the death of Miss 
Minnie A. Arnes, graduate of the Mary 
Fletcher Training School for Nurses, Burling- 
ton, Vt, class 1890. She died at the Graduate 
Nurses' Home, 25 North Union street, Bur- 
lington, February 26, 1908, of pneumonia, con- 
tracted while caring for a patient. 

Miss Arnes' skill as a nurse, kindness of 
nature and strength of character endeared her 
to all with whom she came in contact, either 
in professional capacity or social intercourse. 

Whereas, It has pleased the Omnipotent One 
to remove from our midst one so dearly be-, 
loved for her sterling qualities of heart and 
mind, an earnest worker in the uplifting of 
her profession, realizing the loss our associa- 
tion has sustained ; be it 

Resolved, That we, the members of the 
Graduate Nurses' Association of Burlington, 
Vt., her classmates and co-workers, desire to 
express our grief in our own loss, and to ex- 
tend to her sisters, brother and more immedi- 
ate friends our sympathy in their sorrow. 

Resolved, That a copy of these resolutions 
be sent to the family and to The Trained 
Nurse, and be placed on the records of the 
association. 

The friends of St. Anthony Hospital, Car- 
roll, Iowa, are deeply afflicted at the death of 
Miss Catherine Osterhout, which took place 
Jan. 24, 1908. The deceased was graduated 
from St. Francis Hospital, class of 1905. She 



258 



THE TRAINED NURSE AND HOSPITAL REVIEW 



came to St. Anthony Hospital July 5, 1905. 
Here, as in La Crosse, she endeared herself 
to all with whom she came in contact. Her 
charity was unfeigned, her devotedness to her 
profession exemplary, her self-sacrificing spirit 
the watchword of her sister nurses, who loved 
her as a mother. "Do as I have done," she 
may to each nurse in future say. 

Blanche Brooks. 

Grace Daiker. 



Funeral services for Mrs. Libbey Monroe 
Porter, a Civil War nurse, were held at the 
chapel of J. William Lee, 332 Pennsylvania 
avenue, at 1 1 o'clock Feb. 26. Chaplain Charles 
C. Pierce, U. S. A., officiated, and the inter- 
ment was in Arlington. 

At the outbreak of the Civil War Mrs. Por- 
ter entered the service of the United States as 
nurse. She was one of the oldest surviving 
women in this corps. She also served during 
the war with Spain. 

Mrs. Porter was about seventy years old, 
and had been the president of the Army 
Nurses' Association of 1861 to 1865 ; a member 
of Sheridan Corps, W. R. C. ; color bearer of 
the Edith K. Roosevelt Auxiliary, U. S. S. W. 
v.; a member of the Red Cross, and other 
patriotic relief associations. 



Mrs. Clara V. Raddatz, the wife of Prof. 
Charles F. Raddatz, vice-principal of the City 
College, died Feb. 13 at her home, 3212 Auch- 
entoroly terrace, Baltimore, Md. She was in 
her seventieth year. 

Mrs. Raddatz served as an army nurse, and 
was signally honored by being complimented 
in a general order issued by General Hood for 
"gallant services" in nursing the Confederate 
wounded. At a reunion of Hood's brigade, 
which took place at San Antonio, Texas, Mrs. 
Raddatz was chosen a member of the "Associ- 
ation of Survivors" of that gallant band. 



Mr. Edward L Dodder, 

Omaha, Nebraska. 
Our dear Friend and Brother: 

Whereas, The Allwise Ruler of the Universe 
has permitted the unspeakably sad accident that 
has taken from you a most loving and tender 
wife and from us a true and loyal sister and 
helper; and. 

Whereas, Bertha S. Teddrowe Dodder was 



the organizer of the Nurses' Club of Omaha 
and its efficient president for three successive 
years, thereby giving it permanent establish- 
ment ; and. 

Whereas, Her beautiful, unselfish character 
and labors of love for others, so strikingly 
manifested even in her last sad suffering hours 
of life, thereby endearing her to us even more 
than ever; therefore, it is hereby 

Resolved, By the Nurses' Club of Omaha 
that we deeply mourn her untimely death and 
our great loss of a most cheerful and loving 
companion in our profession of labor and love 
for suffering humanity. 

Resolved, further, That we extend to you 
our deepest sympathy in this your time of 
uimtterable loss and sorrow. And we com- 
mend you and ourselves to Him who said 
"What I do thou knowest not now, but thou 
sliall know hereafter," and together await that 
day. 

Revolved, That a copy of these resolutions 
be published in The Trained Nurse, and that 
a copy be spread on the record of the Nurses' 
Club of Omaha. 

Frances Elmer, 
Anna Grote, 
Eleanor Koran, 
Committee. 



Miss Margaret Porter, of the class of 1893, 
died January 24, 1908, at the City Hospital, 
Wilkes-Barre, Pa., where she had made her 
home and filled the position of bookkeeper and 
clerk for the last ten years, and where she 
had been kindly looked after by her sister 
nurses and friends during her frequent at- 
tacks of illness. 

Whereas, our Heavenly Father has seen fit 
to relieve her of her sufferings, be it there- 
fore — 

Resolved : That we, as an alumnae associa- 
tion, express our love and sympathy to her 
family, and be it further — 

Resolved: That a copy of these resolu- 
tions be sent to her family, also entered on the 
minutes of our association, and sent to The 
Trained Nurse. 

Mrs. Etta Roache, 
Miss Emma Lewis, 
Miss Clara Tregbourn, 

Committee. 



(^Continued on page 272.) 



Ciie €Ditor 6 letter-bojc 



The Male Nurse. 

To the Editor of The Trained Nurse: 

From time to time I have noticed in your 
columns articles pertaining to the male nurse. 

Being myself a male nurse of over seven 
years' experience I feel anxious to have my 
brothers in the profession know how I feel in 
regard to our side of the question. We are in 
the minority, always have been, and no doubt 
always will be. I am free to say the vast ma- 
jority of cases are and should be cared for 
by the fairer sex. 

I am just as positive in making the assertion 
that there are certain kinds of cases where an 
intelligent male nurse can get just as good 
results and give better satisfaction to the pa- 
tient than the female nurse. 
" I am fully satisfied that some men who 
practice nursing are not what they should be, 
and ought to be prohibited from being allowed 
the responsibility of having the sick entrusted 
to their care. 

Some time ago I had occasion to talk with 
one of the most prominent surgeons in New 
England, and he very frankly told me he 
would not erriploy a male nurse in any case. 
And why? Just because several years before 
he had tried one or two and they were not 
faithful to their trust. In some cases he pre- 
ferred male nurses, and upon employing them 
found them under the influence of liquor and 
doing other things which no gentleman, say 
nothing of a nurse, would be expected to do. 

Under these circumstances, could any nurse 
blame the doctor for the stand he took in re- 
gard to the male nurse? 

With all due respect to the female nurse, I 
call to mind several cases where their conduct 
was as unbecoming, and perhaps worse, than 
the cases already mentioned. No one would 
entertain the thought for one minute that 
these were fair examples of the female nurse, 
but it just goes to prove the bad ones are not 
all on one side. They are just unfortunate 
examples with which every class and profes- 
sion have to deal. 

If only the nurses in these particular cases 



had to suffer by their actions no one would 
care; but it throws unjust criticism on those 
who have their work at heart and are doing 
all they can to elevate the profession. 

While every man is expected to earn a liv- 
ing, dollars and cents should not be considered 
everything. He should endeavor to attain a 
good reputation, and his character should be 
above reproach. 

I, for one, would like to see some legisla- 
tion taken to prohibit any nurse — male or 
female — from practicing who had been found 
guilty of misconduct or neglect in any way. 

Some have raised the objection that the male 
nurse is not gentle and is noisy; that he is 
careless and has no feeling. In some cases 
this may be true, and such men should be 
made to see it and not stand in the way of 
others who are endowed with the qualities 
which they lack. 

Let me note one case which will illustrate 
my theory. Some time ago I was called one 
day to a patient, sixty-two years of age, suf- 
fering from uremic convulsions. When I ar- 
rived, found the patient in a profound coma, 
and the case looked absolutely hopeless. The 
family were well to do, and I suggested that 
we have another nurse. The wife fully real- 
ized her husband's condition, and instructed 
me to call another male nurse at once. At 
that time I could not recommend any one 
nearer than Boston, and by the time he ar 
rived we might have no use for him. So I 
suggested to the physician that we have one 
of the female nurses in the city. 

The wife said her husband was very nmch 
opposed to having a woman around him when 
he was sick, but finally reluctantly consented. 
The nurse came, and for the next forty-eight 
hours we worked almost constantly, as many 
of you know who have had uremia to contend 
with. 

At the end of that time the patient showed 
sign of improvement, and in a week's time 
began to convalesce. In twelve days Miss 

• was discharged and I was retained eleven 

weeks. 

And why — not because of financial reasons, 



260 



THE TRAINED NURSE AND HOSPITAL REVIEW 



for they paid me two dollars a day more than 
the other nurse. 

Certainly not for lack of professional abil- 
ity, for she is considered to be and certainly 
is one of the best in the State. It was jusi 
this — for reasons of his own he preferred to 
have a man care for him rather than a woman. 

I think this will substantiate what I have al- 
ready said, that in such cases as this and 
many others I might mention good male nurses 
will always be appreciated. 

Verson M. Boothby, R. N. 

+ 
Changes in the Training School. 

The following letter is reprinted from the 
"Alumnae News," the magazine of the New 
York Hospital Training School Alumnae As- 
sociation. 
My dear Miss Young: 

In reply to your request that I formulate 
the reasons which led to the shortening in the 
course of training for nurses at the New York 
Hospital from three to two years, I would 
point out first that most critics of the change 
miss the main point at issue. There have been 
proposed two changes in the curriculum for 
nurses and not one, and the success of the new 
plan depends on the adoption of both changes. 
These innovations are, first, the reduction of 
the period of training to two years, and, sec- 
ond, the placing of graduate head nurses in 
charge of the wards. Of these two the latter 
is the important change and the one which is 
overlooked and neglected by all the criticisms 
of the proposed system which have come to 
my attention. 

The duration of the term of service is in 
comparison with this really radical suggestion 
of minor importance. The only question is, 
how can the pupil nurses be trained to the 
best advantage to make them efficient helpers 
in the sick room, trained to respect and ob- 
serve the foibles and idiosyncrasies of the 
individual invalid and to enforce order and 
routine in the mode of life of persons suffer- 
ing from illness, who when healthy, may be 
accustomed to neglect and disobey all the com- 
mon rules of health. 

The old curriculum gave the pupil nurses a 
certain amount of theoretical instruction, 
whether wisely selected or not is a question 
which has had a full discussion elsewhere. I 
have no doubt that a sufficient amount of 
theory can be given the nurses in the time 



available during a two years' course of resi- 
dence in a large general hospital like the New 
York Hospital. 

The work of a nurse is concerned witli the 
care of the sick, and amounts to nothing if it 
is not practical, and I believe she has no use 
for knowledge either theoretical or practical 
concerning such medical subjects as "Albumi- 
nuria Glycosuria indicanuria" or "Repair of 
wounds," or "Physiology of heat loss and sup- 
ply," which occupied equal prominence in the 
published curriculum of the old three year 
course with the purely nursing subjects of 
"Care of patients before, during and after 
operation," for example. 

The argument that such theoretical studies 
do no harm even if no immediate good results 
is fallacious, for it is far from harmless to 
distract a tired woman from her important 
and useful work with details even of element- 
ary science which can be of no use to her. 

The sins of the old curriculum in regard to 
theory, however, were born of a desire to bet- 
ter the status of the nurse and may be for- 
given, just as they will be forgotten as soon as 
corrected. The errors of the old curriculunr 
in its teaching of practical nursing are not so 
easy to overlook. The serious results which 
have followed from the use of hot water bags 
that were too hot, from burning alcohol in the 
unskillful application of cups, and from other 
therapeutic measures entrusted to nurses, have 
been a direct sequence from the custom of al- 
lowing pupil nurses to act as instructors of 
other pupils in their ward work, and of plac- 
ing junior nurses on n'ght duty without proper 
superintendence, or even with none at all. 

I would not have you infer from this state- 
ment of my views that the New York Hos- 
pital has been a flagrant example of all these 
errors. Nevertheless, it has been a victim of 
the system and has not been entirely free from 
slighter cases of such "errors of judgment." 

It is believed that such mistakes will be 
lessened by the presence in the wards of grad- 
uate nurses who will act as instructors and 
head nurses during the day hour. It is not 
proposed that these graduate nurses shall hold 
the positions of head nurse for short periods, 
nor that the appointees shall be recent gradu- 
ates from the hospital. On the contrary, it is 
expected that older nurses, who have had ex- 
perience in institutional work will be secured 
to take these positions, and that they will be 
glad and anxious to continue as such ward 



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THE FEEDING 
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THE prime requisite in the successful feeding of invalids is individual- 
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patient. ^ Nurses, on whom so much depends in the proper feeding of 
the sick and convalescent, will find in 

BENGER'S FOOD 

a product of first importance for promoting a maximum degree of nutrition 
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. A Sample fackage, also an interesting little booklet, ' ' On the 
Rearing of Infants," zvill be sent to nurses on request. 

BENGER'S FOOD, Ltd. 

Dept. 14, 78 Hudson Street, New York City 

LAMONT, CORLISS & Co., Sole Importers 




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and surgeons because they recognize Its per- 
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and aids la restoring normal conditions. 

Sulphur has been for generations an un- 
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262 



THE TRAINED NURSE AND HOSPITAL REVIEW 



instructors for periods of three to five years. 
It is believed that the holders of such posi- 
tions will command the appointments to va- 
cancies in other institutions as assistant super- 
intendents and superintendents of training 
schools. In this way all the work of the pupil 
nurses will be under supervision throughout 
the busy hours of the day nursing. 

One of the criticisms of the proposed change 
has been that the nurse would lose the ad- 
vantage of serving as head nurse and that she 
would not secure a feeling of self-reliance 
which is to be obtained by such service. It is 
believed, on the contrary, that the nurse sec- 
ond in command in such a ward would have 
fully as much responsibility as would be good 
for her, and that the added experience under 
skilled superintendence would fit her better 
for her future work. 

A great deal of criticism has been raised 
concerning the difficulties of giving a sufficient 
amount of practical instruction in two years' 
time, and many special pleas have been made 
for the continunce of a three years' course, be- 
cause of the advantage of having a senior staff 
of nurses on duty. But under the old system, 
which included the senior staff of nurses, the 
most important and most responsible posi- 
tions were never taken by the older pupils of 
the school. I refer to the pernicious habit of 
placing junior nurses on night duty in charge 
of medical and surgical wards, at which time 
the help of physicians could be summoned less 
speedily than in the daytime, and when fewer 
nurses were on hand with not more than a 
single graduate night superintendent to assist 
in the care of two hundred or three hundred 
patients. It would be my hope that the term 
of night duty should come to be considered 
the most responsible and the highest position 
that a pupil nurse could be asked to assume 
in any hospital service, for I fully believe that 
a nurse's self-reliance can be better trained, 
and is better trained, during her period of 
night duty than as head nurse of a ward when 
she would be harassed by the many petty 
details of caring for and overseeing the work 
of other nurses. 

A further criticism has been made that the 
adoption of a two years' course by the New 
York Hospital would compel other hospitals to 
follow this example and that smaller hospitals 
would not be able to give an efficient training 
within that period of time. I believe that each 
hospital must settle this question for itself, and 



I do not believe that any hospital should feel 
bound to follow the example of the New York 
Hospital unless persuaded that it is to its 
advantage to do so. I do not see any reason 
why the small hospital should not stick to the 
tliree-year course, and I think it would be 
advantageous for the pupils in some of thcni 
if the course were made four years instead 
of three. 

What I have written above applies to the 
Xew York Hospital and with equal force to 
any large metropolitan hospital with an active, 
ever-changing service of acute disease. 

It is my firm belief that under such a system 
the nurses will be better trained than ever 
before, and that under such a system two 
years is ample time to accomplish this better 
training. Very sincerely yours, 

Sam'l W. Lambert. 

4> 
Criticism of a Training School. 

To the Editor of The Trained Nurse: 

I send a newspaper clipping of a hospital 
strike. Perhaps it will not help out any, but 
nurses are long suffering, and I have heard 
from other sources of the genuine savage love 
of cruelty d'splayed by the superintendent 
mentioned. There is another hospital in the 
same city that ought to have had the search- 
light of publicity turned on its treatment of 
nurses, and consequent lack of care of pa- 
tients. The original course of training was 
fourteen months. Then in their circulars of 
information to candidates they stated the term 
to be two and one-half years. The nurses 
often worked eighteen hours a day, and I 
know of at least three nurses who never had 
even an hour off duty for three months. There 
were usually nine in training; supposed to be 
a hospital of fifty beds— actually forty-five 
beds. Such unspeakable quarters for young 
women who all came from fairly good homes! 
Each nurse was said to have one-half of every 
ninth Sunday (if she could be spared). Six 
had served from eighteen months to two 
years before they found out they had to serve 
three years. They had enough to eat, such 
as it was. The Superintendent of Nurses was 
kind. She was not to blame. I know now 
that it did not deserve to be called a training 
school ; but what does a girl from the country 
know about such things until too late to turn 
back? Is it any wonder some become callous 
to other people's suffering when they must 
endure so much themselves? The six nurses 



ADVERTISEMENTS 




264 



THE TRAINED NURSE AND HOSPITAL REVIEW 



stated their grievances to the board and asked 
for a shorter term of two years. Some of the 
complaints were granted as just, but the hours 
of overwork they said could not be remedied, 
besides nurses should learn to be on duty 
many hours at a time to fit them for private 
practice. As to shortening the term, they 
could not. It would establish a bad prece- 
dent for future classes. They acknowledged 
the papers were misleading, and said no more 
sliould be sent out until corrected. Now they 
have succeeded in getting the former fourteen 
months' graduates to return a few at a time, 
and serve three months longer in the hospital, 
and in addition give three months' gratuitous 
service on obstetrical cases, twelve in number, 
whenever called on. In return the hospital au- 
thorities will give them new diplomas saying 
they have taken a two years' hospital course. 
.Ml of them have been out in successful pri- 
vate practice, the last class for three years. 
The work is the same old grind. They teach 
them nothing new — but probationers are very 
scarce, and students have been leaving to en- 
ter better equipped hospitals. M. B. M. 

A Slight to Colorado Springs. 

To the Editor of the Trained Nurse: 

The recent appointment of a Pueblo nurse 
to fill the vacancy on the State Board of Nurse 
Examiners, caused by the expired term of the 
Colorado Springs representative, has called 
forth a storm of protest from interested mem- 
bers who consider it an outrage that such 
misrepresentations of the true state of things 
should have been made to the Governor, poi- 
soning his mind against the retiring member 
who had done good work for her term of 
three years, leading him to believe that she 
was "entirely uneducated and most unsuited 
to the position," whereas she is really a Bach- 
elor of Arts and a graduate of the Episcopal 
Hospital, Philadelphia, also has had a post 
graduate course in a New York hospital, and 
has served with credit as president of her local 
association for two years. 

As vacancies have occurred on the State 
Board the Springs nurses have not interfered 
in any way, leaving Denver and Pueblo to 
recommend to the Governor those they wished 
to represent them, and feel that Colorado 
Springs in now entitled to the same courtesy 
and consideration from them. 



They thoroughly endorse the Pueblo nurse's 
appointment as Pueblo's representative, but 
naturally resent being cheated out of their 
own. 

With Pueblo's new member and the present 
secretary, they feel that they have at least 
two members on the State Board of Nurse 
Examiners who are a credit to the profession 
in every way. 

This opposition to the rights of Colorado 
Springs by certain members of the State 
Board is supposed to be retaliation for the 
action taken by the Colorado Springs mem- 
bers in withdrawing from an association 
which could in no sense be called representa- 
tive, as out of 600 odd nurses in the entire 
State only 70 are members. 

A Colorado Springs Nurse. 

+ 
A Nurse's Enterprise. 
To the Editor of The Trained Nurse: 

Some readers of The Trained Nurse may 
be interested in knowing something about the 
Harrison-Chappie Hospital, as it is a hospital 
venture of two nurses. Chanute, Kansas, is a 
town of about ten thousand inhabitants, who 
have not jet learned to fully appreciate the 
value of hospitals and professional nursing to 
the sick. 

Nearly two years ago, acting under the ad- 
vice and encouragement of a few of the doc- 
tors (who had vainly urged the city to estab- 
lish a hospital), Miss L. Ellen Harr'son, of 
Wesley Hospital, 1902, and Miss Bertha Chap- 
pie, of Levering Hospital, Hannibal, Mo., 1905, 
fitted up a moderately convenient dwelling 
house as a private ten-bed hospital. Miss Har- 
rison, assisted by Miss Hovey, is still main- 
taining the hospital (Miss Ciiapple having mar- 
ried a patient within six months after the open- 
ing of the hospital). One hundred and thirty- 
one patients have been cared for, ninety-one 
operations have been performed, with a mor- 
tality of only eight. 

The hospital is making something more than 
expenses, the people are becoming interested, 
and talk of a city hospital building, so tliat 
these nurses feel that they are doing some 
pioneer missionary work for the sick, and hope 
they may encourage others to go and do like- 
wi.sc L. Ellen Harrison. 



ADVERTISEMENTS 



Rational T hera peutics 

is based upon clinical experience. Remedial agents 
are judged by results obtained in practice. Med- 
icine is far from being an exact science and its 
art depends less upon Theory than on Common 
Sense. 




acts by virtue of no separate ingredient, but by 
the combination of digestive and enzymogenic 
agents which secure results by stimulating im- 
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In doses of Powder 20 grs.; Tablets, 4 to 6; Elixir 
1 tablespoonful after meals. Samples on request. 
Careful prescribers always specify " N. Y. P. A.' * 

THE NEW YORK PHARMACAL A55W., Yonkers, N. Y. 








'Antikamnia & Codeine Tablets'* in Grippal Conditions 

Wlieji you write AtivL'Tlisors, pluiisc iiioiidMii Tiik 'I'uainii;!) Nuuhid. 



Clje hospital 3eiet)ietu 



Mercy Hospital, Des Moines, la. 

The plans have been drawn and contract 
let for the new $65,000 addition to Mercy 
Hospital, which will be begun at once. The 
new wing will give this hospital a capacity 
of from 180 to 200 beds, making it one of 
the very best institutions of its kind in the 
West. 

+ 
New Mexico Hospital. 

The Presbyterian Church of the United 
States proposes to build in New Mexico a 
great hospital for the treatment of consump- 
tion at a cost of $1,000,000. A site near 
Albuquerque has been chosen. 

+ 
Southside Hospital. 

Contracts for the entire building and final 
completion of the new Oliver Memorial An- 
nex to the Southside Hospital, Pittsburg, were 
awarded to James Stuart, constructing en- 
gineer, of Sixth avenue, who has been i\ork- 
ing on the foundation for the new building 
during the past two months. The award of 
the final contract, which is a general one, 
calls for the completion of this handsome 
building by August 15, when it will be thrown 
open for the reception of patients. 

The new hospital, which is the gift of the 
late James B. Oliver, is to be one of the most 
modern and best appointed institutions of its 
kind in the State, and will give to the South- 
side the first complete institution on a modern 
basis. The new building is to be five stories 
high, with a frontage of 120 feet in Twen- 
tieth street, and a depth of 80 feet in Jane 
street. It is separated from the old hospital 
building by an alley, and the plans call for 
the construction of a tunnel under the alley 
connecting the new and old buildings, and 
also an overhead bridge joining the upper 
floors of the two structures. 

There will be 140 private rooms provided 
on the five floors, besides the general wards, 
of which there will be one on each floor. 
Operating rooms arc to be of white tile and 



lighted with special plans for an abundance 
of natural and artificial light. 

When all is completed it is expected to 
turn the new building into the general hos- 
pital and use the present structure, which is 
much the smaller, into the receiving depart- 
ment, with offices, nurses' quarters, assembly 
rooms and other executive departments. To- 
gether, the structures will make a large hos- 
pital, well equipped for the work to be 
handled. 

+ 
Seattle's New Hospital. 

Seattle is to have a pulmonary hospital. It 
was decided at the close of the first meeting 
of the Washington Society for the Preven- 
tion and Relief of Tuberculosis to incorpor- 
ate at once and use for the enterprise the 
money that has been bequeathed and contrib- 
uted for this purpose by the Denny family, 
amounting in all to $50,000. A site for the 
new institution will be selected later. Of the 
money to be used for the purpose, the late 
Sarah Loretta Denny bequeathed $40,000, 
$10,000 of which is immediately available, and 
her niece. Miss M. Lenora Denny, contributed 
$10,000. 

Dr. W. R. M. Kellogg, the secretary of the 
society, announced that the following will he 
the incorporators and act as the first boapd of 
trustees of the proposed hospital: R. H. 
Denny, Samuel Hill, Joshua Green, J. W. 
Clise, A. S. Kerry, James S. Goldsmith, Dr. 
J. B. Eagleson, Dr. C. A. Smith and Dr. W. 
R. M. Kellogg, the founder of the society. 
+ 
An American Hospital. 

If plans now being discussed arc carried 
out, an American hospital will be estaldishcd 
in Guadalajara, Mexico, within the next few 
months. The present hospital movement was 
started by Dr. A. W.. Parsons, formerly of 
Mexico City, and the idea is meeting with 
general favor among colony members. 

The need of an American hospital in Guad- 
alajara is generally recognized, and on several 



ADVERTISEMENTS 



Food Analysis 



The examination of cereal foods by chemical analysis as usually 
carried out by our Food Commissioners, is apt to be, in some cases at 
least, misleading. 

While Inorganic Chemistry may be termed an exact science, the 
nutrition of the body tissues is by no means such, and to try to esti- 
mate the true "food value" of an organic vegetable product, for ex- 
ample, grape-nuts, from the findings of the laboratory alone, is mis- 
leading in the extreme. 

A chemist may correctly assert that sugar or butter contains 
more Calories per cent than grape-nuts. But, to live on sugar or but- 
ter is at once seen to be impossible, while persons have been actually 
sustained for months on grape-nuts and milk or cream, when every- 
thing else tried had proved unavailing. The reason is, grape-nuts 
contains in promptly available form all the various food elements in 
wheat and barley — the proteids, carbohydrates (the latter largely soluble 
or easily made so in the system), and those highly important "cell- 
builders" the organic, elemental salts — phosphates, etc. 

These salts are required in such small amounts by the system that 
it is no wonder they .have been overlooked by many. But biology 
teaches that protein 'and water alone cannot produce new cells — that 
phosphates, etc., are absolutely necessary. 

Grape-nuts, made of whole wheat and barley, contains this cell- 
building material so essential to metabolism, yet not measurable in 
Calories ! 

The practical, clinical and dietetic value of grape-nuts far exceeds 
any mere laboratory estimate, as has been proven by thousands of 
cases, over a period of a decade or more. 

Liberal samples will be sent prepaid to any physician who desires 
to test for himself the actual food and tissue building value of grape- 
nuts, and who will send name and address to 

POSTUM CEREAL CO., LTD., 

Battle Creek, Michigan, U. S. A. 



When you write Advertisers, please mention The Trained Nuksb. 



268 



THE TRAINED NURSE AND HOSPITAL REVIEW 



occasions in the past the establishment of such 
an institution has been talked of. 

The plans as now discussed contemplate the 
appointment of a committee to take charge 
of the hospital project and arrange for the 
funds necessary for the establishment of the 
institution. Later a 'permanent board of man- 
agers will be chosen. It is suggested that 
monthly subscriptions be collected for the sup- 
port of the hospital at the start, the regular 
subscribers to have the advantage of reduced 
rates at the hospital when ill. For other pa- 
tients there will be a uniform scale of prices. 
The American physicians of the city will form 
the hospital staff, taking charge of the hos- 
pital by turns and giving free service to all 
charity patients, 

,+ 
Freedmen Hospital. 

The new $500,000 Freedmen Hospital of 
Washington, D. C, was opened Feb. 25. By 
many this new hospital is considered the most 
modern and best equipped south of New York 
City. It is constructed of brick and cement, 
and is fireproof throughout. Accommoda- 
tions have been made for 200 patients. 
+ 
Garretson Hospital. 

The new building of the Garretson Hos- 
pital, on Hamilton street west of Eighteenth, 
Philadelphia, Pa., was formally dedicated with 
impressive ceremonies March 2. The hospital, 
which will accommodate over 50 patients, is 
situated in the heart of a large manufactur- 
ing district, and upon the installation of the 
ambulance service will be closely connected 
with the Samaritan Hospital. Both institu- 
/ tions are under the general control of Temple 
College. 

During the fiscal year recently ended 7,136 
patients were treated in the hospital proper, 
and 20,389 dispensary cases were attended by 
the hospital staff. A large percentage of the 
latter came from the neighboring factories. 
The corps of nurses in the new building will 
be in charge of Miss Katherine E. Nagle. 
+ 
Grace Hospital. 

An appeal for aid has been made by Grace 
Hospital, New Haven, Conn., which was the 
scene recently of a disastrous fire, and the 
public of New Haven is asked to contribute 



funds sufficient to place the hospital once 
more on its former footing of efficiency. 

Work has already been started toward this 
end, and the building is being temporarily en- 
closed to protect what is left from the 
weather. 

A meeting of the insurance adjusters was 
held with the hospital directors, and alreadv 
permission has been granted to enclose the 
building so that the work of repairing the in- 
terior may be commenced as soon as possible. 

The appeal also calls for the public to aid 
the nurses and hospital attendants, who in 
their noble devotion to their duty during the 
fire lost a great part of all that they pos- 
sessed in the building, some of them losing 
everything except what they had nprin their 
persons. 

+ 
Dedication of Clinic. 

The Eye, Ear, Nose and Throat Hospital 
and the new Clinic building for the poor of 
New Orleans, La., was formally dedicated 
Feb. 22. This institution was founded in 
1889 by Dr. A. W. de Roaldes, who is still 
head of the hospital and one of its most 
ardent workers. Its first home was a modest 
private residence at 28 South Rampart street. 
Afterward it was moved to 203 North Ram- 
part street. Here it was many years, and, 
finally outgrowing the place, it was decided 
to build a permanent home. The new clinic 
cost $50,000, besides the smaller buildings 
connected with it. 

The building is handsomely furnished 
throughout, and its equipment is the most 
modern that science has invented, and is not 
surpassed in this country. The new building 
was completed last March. 

The clinic is nonsectarian and is entirely 
free to the poor of the community. None of 
the physicians on the staff, either resident or 
visiting, receive any compensation whatever, 
they donating their services to charity. 

+ 
Atlantic City Sanitarium. 

In the will of Charles E. Wood, a real 
estate operator who died recently leaving an 
estate valued at more than $1,000,000, pro- 
vision is made for the establishment of a san- 
itarium at Atlantic City at a cost of about 
$300,000, and which is to be on the lines of 
the Kellogg Sanitarium at Battle Creek, Mich. 



ADVERTISEMENTS 



RICH RED BLOOD 

OR BLOOD RICHNESS 

Is the main desideratum in many cases. Richness of the circulating fluid in those important basic 
elements of vitality — haemoglobin and oxyg^en. 

?6pro-Aaft$aiv ("(judc") 

INFUSES THIS DESIRABLE RICHNESS IN CASES OF 

AN/EMIA, CHLOROSIS, AMENORRHEA, DYSMENORRHEA, RICKETS, 
BRIGHTS DISEASE, Etc., 

By furnishing these necessary haemoglobin-making and oxygen-carrying elements — Iron 
and Manganese — in a form for almost immediate absorption. Both repeated "blood counts" 
and clinical experience go to prove this statement. 

PEPTO-MANGAN " GUDE " is put up only in bottles holding I xl. 

Prescribe original packages, Doctor, and thus avoid substitution. NEVER SOLD IN BULK* 

Samples and literature upon application. 



M. J. BREITENBACH COMPANY, 



LABORATORY. 

LEIPZIG. GERMANY. 



NEW YORKi 



Lactated Infant Food 

The Perfect Substitute for Mother's Milk 



Comparative Analysis of Lactated Infant Food and Human Milk 



Woman's Milk 
Analysis of Henry & Chevellier 

Water 87.98 



Sugar. 

Nitrogenous Matters, 

Fat 

Salts 



6.50 

1.52 

3-55 

•45 

Reaction Alkaline 



Lactated infant Food 
(300 Grains) 

ipt. milk, ipt. cream, Ipt. water 

Water 87.50 

Sugar. 5.28 

Nitrogenous Matters. . . 3.63 

Fat 3.15 

Salts 44 

Reaction Alkaline 



Physiciani who wish to give Lactated In- 
fant Food a careful trial tnay have samples 
sent direct to patients by forwarding to us 
names and addresses 



WELLS & RICHARDSON CO. 
BURLINGTON, VT. 



When you write Advertisers, please meullon Taiii Tuainkd Nubsb. 



Book B^ebietofi 



The Good Neighbor in the Modern City, 
by Mary E. Richmond, author of "Friendly 
Visiting Among the Poor," General Secretary 
of the Philadelphia Society for Organizing 
Charity. Price, 60 cents, postpai*!. For sale 
by the Lakeside Publishing Company. 

Here is a little book full of ideas I It will 
make you think, but it will not give you a 
headache. The object of the book is to in- 
crease charity and direct it along practical 
lines, so that it will achieve results. On such 
a subject few are better qualified to speak. 

The principle which Miss Richmond would 
inculcate is neighborliness. Commencing with 
the parable of the Good Samaritan and end- 
ing with the quotation, "He that loveth not 
liis brother whom he hath seen, how can he 
love God whom he hath not seen?" the whole 
book is an elaboration of the commandment, 
"Love thy neighbor as thyself." But it does 
not stop there. With plain and simple logic, 
clear to any intelligent person, Miss Rich- 
mond proves that a proper neighborliness is 
the most likely solution of the great social 
difficulty — poverty. She proves that it is the 
surest, quickest and cheapest because the least 
wasteful way to right our social wrongs — a 
means as satisfactory to the giver as to the 
receiver when once understood. And this 
proper neighborliness is well and clearly de- 
fined. 

While we have never given a tenth, or even 
a hundredth, as much thought to these ques- 
tions as has Miss Richmond, we are delighted 
to find that many of our independent conclu- 
sions agree with hers. Notably, she does not 
believe that charity can be reduced to a sys- 
tem, and she thinks we are too apt to under- 
value personal, unorganized charity. To 
quote a few of her own words on this point : 
"There are many things that the good neigh- 
bor cannot safely leave to any agency, and 
this conviction, which I hold very firmly, 
would seem to be my chief qualification for 
the present undertaking." 

But Miss Richmond does not depreciate the 
value of organized charity. Far from it. She 



simply admits it cannot stand alone, or, rather, 
has no life alone, and is only an instrument 
for good when in the hand of the good neigh- 
bor. Confined largely to New York City, our 
own experiences witli organized charities, out- 
side of the hospital field, have been very un- 
fortunate and depressing. We are, therefore, 
perhaps not competent to express an opinion. 

Miss Richmond also refuses to regard "the 
poor" as a caste — a view to which many peo- 
ple in better circumstances seem to incline, 
cither consciously or unconsciously. 

No one has a better opportunity to see all 
sides of our social system than has the nurse. 
This book will help her to understand what 
she sees. We advise its purchase, especially 
by district nurses, and assure its readers that 
they will be instructed in every case, and in 
almost every instance interested and enter- 
tained as well. 

•f 

Food and Dietetics, by Alice Peloubet Nor- 
ton, M. A., assistant professor of home eco- 
nomics. School of Education, University of 
Chicago; director of domestic .science. Price 
$1.50. For sale by Lakeside Publishing Com- 
pany. 

This is one of the publications of the Ameri- 
can School of Home Economics, Chicago, 111., 
and like all their works, is written with the 
avowed purpose of being a part of their 
course. 

Let us state at once that it is not a cook 
book. It is the "why and wherefore" of food, 
not how to cook it. In other words, it is a 
purely theoretical work. Although, paradoxi- 
cal as it may seem, its theories arc very prac- 
tical. It is a broad, scientific, but very com- 
prehensible, discussion of the food problem 
in all its branches, cost, its relation to income, 
health, chemical constituents, etc. It con- 
cludes with a chapter on Protein Metabolism 
in its relation to dietary standards, by Otto 
Folin, Ph. D., McLean Hospital, Waverly, 
Mass. 

The entire work is interesting and improv- 
(Continued under Publisher's Desk.) 



ADVERTISEMENTS 



A Superior Surgical Dressing 
Made from the best quality of imported Welsh Kaolin 




A most effective application in all conditions of irritation, 
congestion, and inflammation. Now sold in screw top glass jars 
which can be resealed. 



FREE to Ntirses— NURSES* HANDY BOOK, containing 
much valuable data and useful information connected with a nurse's duties. 



G. W. CARNRICR CO. 

42 Stillivan Street :: :: Ne>v YorK City 



VVlieu ym wiil<" AdvciMiHcrK, please uieiilloii Tub Tkaineu Nuksb. 



272 



THE TRAINED NURSE AND HOSPITAL REVIEW 



3n tlje JBtursing WLovVQ-connnued 



Birmingham, Ala. 

The third annual meeting of the Graduate 
Nurses' Association of Birmingham, Ala., was 
held March ii at the Hillman Hospital. 

After the report of the retiring officers had 
been given, new officers were elected as fol- 
lows: President, Annis E. Stay, R. N. ; vice- 
president, Miss J. T. Dainwood; second vice- 
president, Miss Frances Zinkan. Miss Helen 
McLean was re-elected secretary and treas- 
urer. Miss Mary P. Nicholls was elected 
corresponding secretary. 

Before the meeting adjourned Miss Dain- 
wood read a very interesting paper on the 
organization and success of our association 
and graduate nurses' registry. 

For the success of our association much 
credit is due Miss N. B. Hamilton, our retir- 
ing president. Through her efforts and our 
co-operation we have grown from a chartered 
membership of ten nurses to fifty-three in the 
past three years. 

Our Graduate Nurses' Association, through 
the suggestion of Miss Hamilton, agreed to 
put a district nurse in the field — Miss Fors- 
nian — and her success has been so gratifying 
that we have undertaken even more work for 
next year. 

We have interested some of the charity or- 
ganizations and a number of women in our 
city, and have formed a District Nurses' 
Auxiliary, which has enabled us to employ a 
colored district nurse also, the colored nurse 
working among her own people under the 
direction of Miss Forsman. 

In future we will interest ourselves more 
in the social feature of our meetings and some 
light refreshments will be served. 

Miss Hamilton, in her paper, urged us to 
have ever before us State registration, and 
we shall attain it. "This will give us added 
dignity and a wider scope to our work, and 
may this year prove our loyalty to our asso- 
ciation and to each other, and mark an in- 
crease in members and in our usefulness." 
Mary P. Nicholls. 



Pennsylvania State Society. 

The next semi-annual meeting of the Grad- 
uate Nurses' Association of the State of Penn- 
sylvania will be held at AUentown, Pa., on 
Wednesday, Thursday and Friday, April 22, 
23 and 24, 1908. Nellie M. Casey, 

Assistant Secretary. 
+ 
Personal. 
Miss Hattie Grant, '07, graduate of the Wy- 
oming General Hospital at Sheridan, has been 
appointed assistant chief nurse at Rock Springs 
Wyoming General Hospital. 



The appointment of Miss Agnes S. Ward to 
the superintendentship of the Metropolitan 
Training School has given great pleasure to 
every one in any way connected with the insti- 
tution. Miss Ward is a graduate of one of 
the early classes of this school and a post- 
graduate of the Brookline Hospital, Brookline, 
Mass. 

She spent three years in Congo Free State 
as a medical missionary and about three years 
in private nursing. 

In 1903 she was appointed assistant superin- 
tendent, a position she filled very acceptably, 
displaying marvellous executive ability, great 
powers of organization and absolute mastery 
of even the minutest detail of hospital work. 
The work of imparting theoretical and practi- 
cal instruction to the advanced classes also 
devolved upon her. Her excellent education, 
vast experience in private work and travel 
combined, eminently fitted her for the work. 
Always a tireless student for the benefit of her 
pupils, possessing the happy faculty of impart- 
ing her information in a bright and enter- 
taining way, she attained a degree of success 
reached only by a few. Though a strict disci- 
plinarian, she invariably won the affection of 
her pupils. Her aim was to set before them 
only the highest ideals, to encourage them to 
have an ideal standard toward which they 
were to advance, to be loyal to one another, 
and do all in their power to elevate the stand- 
ard of the nursing profession. 



ADVERTISEMENTS 



The 



'JUlenburgs Foods. 



Provide nourishment suited to the needs and digestive powers of the child from ^>irth 
onward, according to the development of the digestive organs. 

THe •• Allen btirys" MilK Food ''No. 1" 

Designed for use from birth to three months of age, is identical in chemical composition with 
maternal milk, and is as easy of assimilation. It can therefore be given alternately with the 
breast, if required, without fear of upsetting the infant. 

THe •• Allen burys" MilK Food ''No. 2" 

Designed for use from three to six months of age, is similar to "No. 1," but contains in 
addition a small proportion of maltose, dextrine and the soluble phosphates and albuminoids. 

THe ••Allenbtirys" Malted Food ••No. 3*' 

Designed for use after the fifth or sixth month, is a partially predigested farinaceous food need- 
ing the addition of cows' milk to prepare it for use. 

Physicians familiar with the "Allenburys" Series of Infant Foods pronounce this to be the 
most rational system of artificial feeding yet devised. Their use saves the troublesome and fre- 
quently inaccurate modification of milk and is less expensive. Experience proves that children 
thrive on these Foods better than on any other artificial nourishment 

SAMPLE AND CLINICAL REPORTS SENT ON APPLICATION 



THE ALLEN 

TORONTO. CAN^ 



(Si HANBURYS CO., Limited 

LONDON. ENG. NIAGARA FALLS. N. Y. 









*'I"r'I"I'*i 



A Drink in Fevers 



A teaspoon of Horsford's Acid Phosphate added 
to a glass of cold water makes a cooling and refresh- 
ing acidulous drink for the patient during conva- 
lescence from typhoid and other febrile conditions. 

Its superiority over Dilute Phosphoric Acid, or 
any other acid, is due to the fact that it contains the 
phosphates of calcium, sodium, magnesium and 
iron, which means increased nutrition. 

Horsford's Acid Phosphate 

is more palatable and strengthening than lemonade, 
lime juice or any other acidulous drink. 

RUMFORD CHEMICAL WORKS, Providence, R. I. 



^~^•H•^•4•'^^"^^•'^'I"^4^H•4♦4•^••^^'^♦•^^I■^l■■I^^^^I^^^^I^4'♦^^•4^4•^^^♦^•4♦•^'M-^'^^>H•4•^^ 

Wbcn you write Advertisers, please meutlon Tuk Tuaineu Nuksb. 



jleto Kemefiiesi ant. appliancesi 



Evans's Antiseptic Throat Pastilles. 

Mr. Dudley Buck, Jr., writes : 
"Carnegie Hall, New York, Nov. 3, 1900. 

"I take pleasure' in testifying to the excel- 
lence of your Antiseptic Throat Pastilles. 
They are certainly most efficacious." 

+ 
Attention, Superintendents! 

The superintendents and head nurses of 
many hospitals where only a few babies are 
cared for may not know that they can buy 
Pulvola Toilet Powder in large containers 
direct from the manufacturers at a consider- 
able saving over the price^thcy are now pay- 
ing for tlic trade size. 
+ 
Do You Know This? 
It is scientifically true that individuals whose 
duties are intellectual observe especially the 
waste of the nervous .system, particularly the 
brain, and (lie necessity of restoring it. Hors- 
ford's Acid Phosphate supplies that waste and 
gives the feeling and sense of increased intel- 
lectual power, 

+ 
Old Age! 

Old age may "creep on apace," but many of 
the so-called inevitable ills of advancing years 
can easily be corrected by the use of Gray's 
Glycerine Tonic Comp. It improves the diges- 
tion, increases assimilation, promotes normal 
elimination and is a valuable aid in maintain- 
ing the proper balance between waste and re- 
pair. 

+ 
Straight Goods! 

Merle (Burleson Co.) Tex., Nov. 24, I(;'j6. 

The Ansarcin Chemical Co., Winchester, 
Tenn. — Your tablets excel anything it has been 
my pleasure to use; they are exactly as you 
represent them, and no mistake is made by 
any physician using tliem. 

I intend to use these tablets in all my ca.ses 
where they are indicated. With highest re- 
gards, I am, respectfully yours, 

J. P. Carrington, M. D. 



Why Go to Nauheim? 

A pertinent inquiry addressed to: — those 
who have been to Bad-Nauheim, those who 
hope to go and can, and those wlio want to 
go and cannot. If you want to know the 
answer, send for this interesting and instruc- 
tive booklet, which will be sent you free of 
charge. Schieffelin & Co., New York City. 
+ 
Health Flour. 

Our "Health Flour" is a general family 
flour, containing every essential to the growth 
and nourishment of the body, entirely free 
from bran, which will not digest in the human 
.stomach ; invaluable to all who need a recuper- 
ative and invigorating food, and is particularly 
suitable for children. 

Farwf.u, &' Rhines, Watertown, N. Y. 
+ 
Best I Ever Used! 

Ogden & Shimer. — I have used two jars of 

your Mystic Cream and think it the best thing 

I ever u.sed and would not be without it. It 

gives the skin such a soft, velvety feeling. 

Enclosed find an order for twenty-five cents 

for which please send another jar. I have 

recommended it to a number of friends who 

have sent for it and are just as well pleased. 

Miss E. A. Scott, Calgary, Alta, Canada. 

+ 

Packer's Tar Soap. 

Packer's 'J ar Soap, pure as the pines, is 
an ideal cleanser; it is grateful to the senses, 
lathers freely, cleanses thoroughly, neutralizes 
the bad effects of cosmetics and leaves the 
skin delightfully .soft, smooth and pliable. 

+ 
St. Vitus Dance. 

The list of .special remedies is a small one, 
but there is one indispensable medicine, and 
food combined, which is of paramount im- 
portance, whatever else may be prescribed, 
and that is Scott's Emulsion of Cod Liver 
Oil. — Dr. Maude Kent, in American House- 
keeper. 



ADVERTISEMENTS 



The Dangers of Cow's Milk 

THE recent epidemic of Scarlet Fever In Chicago has awakened the whole 
country to the grave danger lurking in the Milk Supply of our large 
cities. Wherever milk is used that has not been properly safeguarded 
from the cow to the consumer, the infant mortality will always be high. 

Coincident with the Chicago Epidemic there comes a Report of the British 
Royal Commission on Tuberculosis. After five years' investigation, the Commis- 
sion confirms the theory of Von Behring, that the tuberculosis of cows is a con- 
stant menace to the human race, and that consumption developed in later life, 
has often been contracted In infancy, from tuberculous milk. 

Nestle's Food 

does not require the addition of milk in preparing it for use, as it is a complete 
diet in itself. The basis of Nestle's Food is cow's milk, so treated and modified 
that it will be easily digested, and will resemble mother's milk in its composition, 
as closely as possible. The milk supplied to the Nestle Factories is collected 
under the most rigid precautions, from cows that are under the constant super- 
vision of the Company's Veterinarians. Furthermore, the process of manufacture 
completely sterilizes the milk. This is fully set forth in our pamphlet, "Recent 
Work in Infant Feeding." A copy of this, with samples of Nestles Food, we will 
be glad to send to any physician. 

H£NRI NeSTLE. 7 2 'Warren St.. New YorK. 



SPRING AND SUMMER CLASSES IN MASSAGE 

THE SYSTEM YOU WILL EVENTUALLY LEARN 
Swedish Movements, Medical and Orthopaedic Gymnastics 

Term: 3 Months Tuition Fee, $60.00 

Course in Electro-Therapy 

Term: 2 Months Tuition Fee, $25.00 

Course in Hydro-Therapy in all its Forms 

Term: 6 Weeks . .... Tuition Fee, $30.00 

SPRING CLASSES OPEN MAY 14, '08. SUMMER ClASSES OPEN JULY 8, '08 

7044 TREATMENTS GIVEN IN 1907 

No Bottor Clinical Exporlenco Rosslblo 

All courses may be commenced at the same time and finished within three months. 

The instruction consists of daily clinical work and practical lessons on patients referred to our clinics from 

the various Hospital Dispensaries. Original Swedish (Ling) system, and Weir Mitchell's Rest-Cure system. 

All pupils attend clinics at several city hospitals. Payments can be made to suit your convenience. Particulars 

and illustrated booklet on Massage upon request. An early application for admission is advisable. 

THE TUITION PEE WILL BE RAISED AFTER OCTOBER 1. 1908 

INSTRUCTORS 



T. D. Tagcart. M.D. (Jefferson Med. College] 
Wm.Erwin.M.D. (Hahnemann and Rush Med. Col.) 
Frank B. Baird. M.D. (Univ. Pennsylvania). 
Max J.Walter (Royal Univ. .Breslau, Germany, and 
lecturer to St. Joseph's, St. Mary's, Mount Sinai 
and W. Phila.Hosp. for Women, Cooper Hosp.,etc). 



Helene Bonsdorff (Gymnastic Institute, Stock- 
holm, Sweden). 

LiLLiE H. Marshall 1 (Pennsylvania Orthopaedic 

Edith W. Knight J Institute). 

Helen T. Walker (St. Francis Xavier's Infirm- 
ary, Charleston, S. C Penna. Orthop. Inst.). 

Wm. H. Montgomery (Penna. Orthop. Inst.) 



Pennsylvania Orthopaedic Institute and School of 

Mechano-Therapy (incorporated) 

\1\\ Green Street. PHILADELPHIA, PA. MAX J. WALTER, Superintendent 



276 



THE TRAINED NURSE AND HOSPITAL REVIEW 



For an Emergency. 

An emergency case of severe and extensive 
burn from falling in hot ash pit, half of right 
leg, including buttocks, and one-third of left 
leg. Immediately on my arrival I dressed the 
wound with Unguentine. Relief came quickly 
after the dressing. In two days the boy w^as 
doing very well, and in a week's time was play- 
ing as if nothing had happened. 

Edward Howard, M. D., 
Denver, Col. 
+ 
Solves the Problem. 

The Allen Healtli Tent is an excellent in- 
vention and I heartily recommend it. Those 
who have this tent will enjoy an abundance 
of pure outdoor air and reap the benefits. 
These tents are good for well and ill. The 
well will flourish the more and the ill will 
improve and get well. The Allen Health Tent 
solves the problem of bedroom ventilation. 
J. N. HuRTY, M. D. 
Sec. Indiana State Board of Health. 
+ 
A Good Thing Cheapl 
If you want a good thing cheap sent twenty 
cents in stamps to Valzahn & Co., Philadel- 
phia, Pa., for their new dropping bottle, the 
most perfect dropper ever offered to the pro- 
fession. See the advertisement in this issue. 
It will drop any liquid not too thick to flow 
easily. No trouble to keep clean. Keeps all 
dust from the contents of the bottle. 
+ 
Post-Hemorrhagic Anemia. 
A good, reliable hematic is early necessary, 
one that can materially hasten hematosis with- 
out endangering the digestive and assimilative 
functions in any way, shape or fashion. 
Pepto-Mangan (Gude) is one of the most 
dependable remedies of this class, and its 
hematopoietic properties are well known. 

+ 
No Longer a Terror. 

Pruritus vulvae and ani, as well as itching 
piles, in my twenty-eight years of practice 
were formerly considered as terrors to physi- 
cians as well as patients. But three cases of 
the first, two of the second, and one of the 
third yielded very readily by the use of 
Resinol. 

Wm. Caspari. M. D., Mitchellsburg, Ky. 



A Unique Product. 

Horlick's Malted Milk is so convenient that 
a delicious food drink may be made in a 
moment by simply stirring the powder in 
water, so stable that it is used in the most 
trying climates, is preserved indefinitely, and 
furnishes the most delicate, palatable and di- 
gestible food product. It has received the en- 
dorsement, not only of eminent physicians 
everywhere, but also the approval of actual 
use irt thousands of homes in all parts of 
the world. — Scientific American, Export Ed., 
July, 1905. 

+ 
Year in and Year Out. 

Antikamnia has stood the test of exhaustive 
trial, both in clinical and regular practice, and 
has been proven free from the usual untoward 
after effects which accompany, characterize 
and distinguish all other preparations of this 
class. Therefore antikamnia and codeine tab- 
lets afford a very desirable mode of exhibiting 
these two valuable drugs. The proportions 
are those most frequently indicated in the 
various neuroses of the larynx, as well as the 
coughs incident to lung affections, grippal 
conditions, etc. — The Laryngoscope. 
+ 
The Human Machine. 

We are pleased to again call attention to 
The Hupnan Machine, the book for the nurse, 
advertised in this issue. From the time it 
first came from the press it has received a 
warm welcome from the profession and its 
excellence is becoming well known. 

Carefully prepared by twelve well-qualified 
specialists it covers a wide field, is thorough 
and makes plain a great deal that every pro- 
gressive nurse desires to know. She who is 
so wise as to get it will find it a help she, 
would not willingly part with. 

+ 
Tonsllitis. 

In treatment the first indication is to in- 
crease local capillary circulation. A local rem- 
edy must fill two requirements, i. e., a deter- 
gent antiseptic and a degree of permanency 
in effect. Glyco-Thymoline, frequently applied 
in a fifty per cent strength with a hand at- 
omizer, produces a rapid depletion of the con- 
gested area through its well-defined exosmotic 
property. 



ADVERTISEMENTS 




TOASTED 
CORN FLAKES 

The package of the genuine bears this signature 



Tmtled Com Flake Co., Battle Creek, Mich. 

Canadun Trxlc Supplied \>i lh> B«lll< Cr»li Toaiird Cofn FUkt Ci>.. L'i'd.. l.ond<if<. Onl, 



Copyright, 1907, Toasted Com Flake Co 



278 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Infant Feeding. 
A great deal of painstaking study has been 
devoted to infant ■diets and the consensus 
of opinion seems to be that cows' milk suit- 
ably modified, is the ideal substitute for 
mothers' milk. But cows' milk, alone, how- 
ever pure, is only suitable for temporary use, 
for it is neither an adequate nor a well-bal- 
anced food for continued feeding. It is 
always desirable, therefore, to increase its 
digestibility and augment its nutritive value 
by the addition of other food substances, and 
this is the particular mission of Bcnger's Food. 



Alcohol Free of Tax. 

An idea is prevalent that denatured alcohol 
and alcohol obtained free of ta.x by hospitals 
under certain provisions of the Treasury De- 
partment are one and the same. This is not 
so. Denatured Alcohol has as a dcnaturant 
a quantity of benzine and wood alcohol, or 
pyradine and wood alcohol, rendering the ar- 
ticle poisonous and unlit for hospital use. 
Alcohol obtained free of tax by hospitals is 
absolutely pure and no change has been made 
in the method to procure it. 

F. O. Boyd & Co., 71 Hudson street, New 
York, N. Y., would gladly acquaint any insti- 
tution with the details connected with the 
obtaining of this article and would make no 
charge for the information. 



Order by Mail! 

There arc few places where a nurse can 
secure everything she needs in her profession. 
In the larger cities the big drug stores have 
special departments in which are sold every- 
thing pertaining to nursing and to the sick 
room. These departments are presided over 
by the most competent buyers, and they sell 
their products at prices often below what the 
ordinary drug stores are called upon to pay 
for theirs. 

These stores make a specialty of mail order 
business, and nurses living at a distance can 
deal with perfect satisfaction. 

One of the oldest and most reliable drug 
houses in the United States is Hegcman & 
Co., 200 Broadway, with its numerous branches 
in New York and Brooklyn. They guarantee 
absolute satisfaction with every purchase. 



Stiefel's Medicinal Soaps. 

The gratifying professional appreciation ac- 
corded Stiefel's Medicinal Soaps in the three 
decades of their existence, best evidences their 
pre-eminence — a po.sition attained and main- 
tained by constant scrupulous selection of 
the best materials and by conscientious care 
devoted to tiietr manufacture. Stiefel's soaps 
are guaranteed to respond to every test for 
purity, accuracy and reliability. More than 
sixty-seven varieties. Send for free booklet 
to Schering & Glatz, Xew York. 

+ 
A Hard Case. 

W. H., aged 5. Whooping cough. Spas- 
modic paroxysms of coughing, sometimes be- 
ing so severe as to cause vomiting. Tenacious 
mucus was present, requiring great expulsive 
effort to loosen it. There was little fever, 
but the patient was much prostrated and weak- 
ened by the cough. Ghco-Heroin (Smith) 
was given in lo-drop doses every two hours 
with good results. This was combined with 
hygienic treatment, the patient being given 
as much of fresh air as possible. In a few 
days the case was discharged cured. 

Arthur B. Smith, M. D., Springfield, Ohio. 

S- 

Announcement. 

The Pennsylvania Orthopaedic Institute and 
School of Mechano-Therapy, Philadelphia, 
begs to announce the opening of the Spring 
class in the Swedish System of Massage, Medi- 
cal and Corrective Gymnastics. Electro and 
Hydro-Therapy, on May 14, and the Summer 
class on July 8, 1908. 

The system taught is the original Swedish 
(Ling) System, as taught in the Royal Gym- 
nastic Central Institute, at Stockholm, Sweden, 
with American adaptations. The students re- 
ceive daily practical lessons and theoretical 
lectures on the different branches taught, as 
well as in anatomy, physiology and pathology, 
lK;sides attending the Nervous and Orthopaedic 
Clinics at three of the largest City Hospitals. 

The tuition fee will remain the same for the 
Spring and Sujnmer terms, but on account of 
the considerable broadening of the courses 
the rates will be increased after October i, 
1908. 

Particulars and application blank may be ob- 
tained by addressing Max J. Walter, Supt. 



ADVERTISEMENTS 







PHILADELPHIA ORTHOPAEDIC 

HOSPITAL AND INFIRMARY 

FOR NERVOUS DISEASES 

School of 
MASSAGE AND ELECTRICITY 

The Original Place and 
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Four months' course of instruction in 
Massaj^e, Swedish Movements and Electricity 

Fee $75 for Massage and $25 for Elec- 
tricity. Board not included 
Payment in advance 

Lectures Given Weekly by Members of the 
Medical Staff of the Hospital 

Practice daily under constant supervision 
Certificate Given 

CClasses are formed in October and 
January. C.Pupils have access to the 
Wards of the Hospital and the numer- 
ous cases referred, from the clinics 

For further information address 

SUPERINTENDENT 


The Nauheim 

T> J_ l- are given by 
^^M«Lllo means of the 

TRITON 

EFFERVESCENT 

Bath Salts 

The preparation of an artificial Nau- 
heim Bath surcharging the water with 
carbon dioxide by adding to a tub of 
water a package of Triton Salts is 
simple to the last degree. We shall be 
glad to send literature and manual of 
the Nauheim Treatment on request. 

THE TRITON COMPANY 

Schieffelin & Co. 

NEW YORK 
Sole Licenues and Sole Aeenta 







The 

Successful 

Treatment 

of 

Coughs 



The successful treatment of coughs 

always depends upon the extent to which general 
as well as local vitality can be raised. This is why 



GRAY'S 



Glycerine Tonic Comp 



accomplishes results in relieving and controlling respiratory 
diseases that are seldom observed with any other remedy. 
It imparts tone to weakened tissues, promotes nutrition 
and increases vital resistance. 

A powerful tonic, a reliable reconstructive 
and a dependable respiratory stimulant. 

THE PURDUE FREDERICK CO. 
298 BROADWAY. NEW YORK 



280 



THE TRAINED NURSE AND HOSPITAL REVIEW 



A Word for Passiflora. 

I consider your Passiflora a good standby, 
casting abominable opiates entirely out of use. 
In looking back over my past and that of other 
physicians in my locality I can see wrecks 
resulting from morphine and opium that would 
not have occurred had we gotten out of the old 
rut and accepted the remedy God designed for 
the nervous system. I regard it as invaluable 
for neurasthenia, insomnia and similar affec- 
tions, and shall always prescribe it. 

J. B. Morrow, M. D. 

Tulsa, Oklahoma. 

The above letter is one of the many re- 
ceived recently from physicians who appreciate 
Daniel's Passiflora. As a true and natural 
sedative it is incomparable. 

+ 
Clinical Popularity. 

Llewellyn Eliot, A. M., M. D., surgeon to 
Providence Hospital and Eastern Dispensary 
and president of the Medical Association of 
the District of Columbia, etc., in an article 
read before the Section on Obstetrics, said : 
"In irrigating these cases we may use the solu- 
tion of bichloride of mercury, carbolic acid or 
any other medication which individual prefer- 
ence may suggest; for my part, I employ a 
solution of Tyree's Antiseptic Powder, which 
is non-poisonous." What can better attest its 
high reputation than the fact that recognition 
is given by so high an authority? A trial 
package will be mailed free of charge. Ad- 
dress J. S. Tyree, chemist, Washington, D. C. 
+ 
Something Good to Eat. 

Kellogg's Toasted Corn Flakes as an appe- 
tizer and food for invalids and convalescents 
furnishes a welcome relief from the usual 
diet. When it seems impossible to prepare 
anything that tastes good to your patient try 
Kellogg's Toasted Corn Flakes, but be sure 
you get the genuine, for there's all the dif- 
ference in the world between "Kellogg's" and 
the imitation. 

Warm the flakes in the oven, being careful 
not to scorch them, as this would impair their 
flavor. Serve with rich cream while still hot — 
your patient will relish it. 

A request on a postal will bring a large 
sample package free. 

Address, Nurses' Department, Toasted Corn 
Flakes Company, Battle Creek, Mich. 



Nurses' Handy Book Free. 

Newark, N. J. 
G. W. Carnrick Company, New York City : 

Gentlemen — Will you very kindly accept my 
many thanks for the Nurses' Handy Book and 
for the order for a jar of Antithermoline? 
I well know the good of the Antithermoline 
in my own family and in private nursing for 
cases of pneumonia. I keep a jar in the house 
all the time. Once more thanking you, I re- 
main, yours very respectfully, M. M. H. 



Many thanks for the books you so kindly 
sent us. The girls think they arc great. 

M, D., Columbus, O. 



Nemo Back-Resting Corset, Suitable for 
Nurses. 

The Back-Resting Corset is a novel and 
most ingenious invention of a famous Amer- 
ican corsetier. It supports and rests your 
back, reduces the size of your waist (without 
lacing) and gives you the new "slender, 
straight-back figure" at its best. All this is 
accomplished by the new corset ; and, another 
thing, the back steels can't "turn" and dig 
into the flesh, no matter how tightly you 
lace it. 

Combined with the wonderful advantage of 
this back-resting device, which is so essen- 
tially necessary to nurses, is the durability 
of the Nemo corsets, all being made so that 
the bones and steels can't cut through, and of 
the finest materials procurable. A Nemo cor- 
set will wear longer and give greater com- 
fort than any corset of the same price now 
on the market. 

+ 

A Merciful Invention. 

Among the many valuable modern comforts 
for both patient and nurse is the Gorham In- 
valid Bed. This bed has long been known to 
the profession, and its many recognized ad- 
vantages have been still further improved 
upon by the Bernstein Manufacturing Com- 
pany, Philadelphia, Pa., who are now making 
it in a form that would hardly seem to admit 
of further betterment. ^ 

A great surgeon called this bed "the most 
merciful invention of the century." 

Upon request a booklet describing this bed 
will be sent free. 



Cable of Contents 



Page 

Opsonins and Medical Advance Gerald B. Webb^ M.D. 283 

An Unorthodox Opinion on Registration, ......... C^«r/^//<? A. Athens 287 

The Advantages of Training Nurses in Families Mrs. L. D. Palmer 293 

Professional Obligations and Recent Criticisms 

Charlotte Mandeville Perry 298 

Obstetrical Nursing in Private Practice Annie E. Hutchison 301 

The Tuberculosis Problem and the Negro Race Mabel Jacques 305 

Report of Case Rachel Ten Eyck 308 

Practical Points , 310 

Extracts from the Journal of a Pupil Nurse 311 

The Diet Kitchen Rosamond Lampman 315 

Editorially Speaking 318 

In the Nursing World 321 

The Editor's Letter-Box , 327 

The Hospital Review v . . 333 

Book Reviews 338 

New Remedies and Appliances 342 

The Publisher's Desk 350 




A Clean, White, Healthy Scalp 

is absolutely essential to the growth and 
beauty of the hair. 

Packer's Tar Soap 

used systematically as a shampoo is a reliable means 
of restoring and maintaining normal 
conditions of the scalp structures. 

Forthirty-five years it has been endorsed and rec- 
ommended by the medical profession as the stand- 
ard soup for the hygienic care of the hair and skin. 

Our little boolclet on " The Value of System- 
atic Shampooine,"with asamplecakeof soap, will 
be sent to nurses who will mention this journal. 

THE PACKER MFG. CO., New York 




When you write Advertisers, please mention Thib Thaineo Nubsb. 



ADVERTISEMENTS 



•'ARMY 

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AND 



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The "Army and Navy" is the only PERFECT Helmet n»de. 

It flt« snugly and holds an ample quantity of Ice which can be moved to any part of the head. 
or centered over the base of the brain, If desired. 

It can be flattened out to form the regular, round-shaped Ice- Bag suitable for use oi any part of th« 
body and especially for the abdomen. 

It Is made of cloth Inserted Maroon Pure Rubber, with screw-cap and unlosable washer. 



ADULT'S SIZE. I2X Inches In diameter. CHILD'S SIZE, 10 Inches In diameter 

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It holds more Ice than other bags, and is lighter in weight. 

It can be perfectly adjusted and secured, and has a smooth and flat bottom 
surface when filled. 

Its long, flat surface, makes the bag specially adaptable for the chest or abdomen. 

It is the leading Hospital Bag and is mnde with our non-leaking, metal screw-cap, 
in both slate and maroon rubber. The Maroon Rubber Bags are fitted with our 
Patented ' Unlosable ' Washers. 



Small Size, Sx9 In. 
Medium " 6x1 1 in. 
Large " 7x1 3 In. 



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wholesale prices. 



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MAKERS OF ADVANCED SPECIALTIES FOR THE SICK=ROOM AND HOSPITAL 
WE SUPPLY HOSPITALS AT WHOLESALE PRICES 



Every Hospital supdlntenoenl. Principal of Training School or Hoipital Buyer shoifld write for Meinecke Cc Company*! 
co m pl ete ca l a l oguc. hancwnmrly illiutrated. tiwwiac theii full iioa of "Advanced Spedaltiet" (or Hoipilal *>—. 



J^fCKSES' LIBRARY 

Jfot to be Removed 






VOL. XL. 



NEW YORK, MAY, 1908. 



NO. 5 



opsonins anlr ;:^etiical 9Hi\)ance 

GERALD B. WEBB, M.D., COLORADO SPRINGS, COLO. 



MEDICINE is constantly charged 
with instabiHty. Because exten- 
sive and spmetimes fundamental changes 
of doctrine are constantly taking place, 
we are told that no reliance can be 
placed on medicine at all. But analysis 
will usually show that doctrines and the 
practice founded thereon were correct 
under conditions then existing, even 
when judged in the light of the stand- 
ards of to-day. 

It is eminently fitting, in a health 
centre for tuberculosis, to speak to you 
to-night of the present knowledge and 
treatment of that and other microbic 
diseases. 

To lead up to this position I must 
give you a short historical summary. 

All modern immunity had its begin- 
ning in the work of Pasteur. In 1879 
Pasteur studied chicken cholera, and 
discovered the cause. His studies be- 
came interrupted by holidays, and, re- 
turning to his laboratory, he found al- 
most all his germs were dead. He tried 
to get fresh growths of them by inocu- 
lating broth, and also inoculating chick- 
ens. The chickens remained, however, 
unaffected, and, thinking his material 
useless, he was about to discard it, when 
it occurred to Pasteur to reinoculate 



these chickens with a fresh, virulent 
culture. To his amazement, this inocu- 
lation of virulent chicken dholera micro- 
organisms left the animal unaffected. 
Thus the secret instinct of genius 
grasped an accidental discovery, and 
won with it a marvelous victory — 3. 
means of weakening powerful bacteria 
and using the same as vaccines to pre- 
vent disease. 

In 1882 Metchnikoflf began working 
on the theory that the amoeboid cells, 
corresponding to our white blood cor- 
puscles, in sponges and lower animals 
possessed digestive functions. In the 
study of inflammation, he found that 
when a thorn was placed in the larva 
of a star fish it was surrounded by these 
cells. In investigating a disease in the 
minute, transparent water flea, due to 
a vegetable parasite, MetchnikofT ob- 
served the battle between the invading 
parasites and the leucocytes (white cor- 
puscles). 

From these studies came his well- 
known theory of phagocytosis that is to 
say, that the w^hite blood cells, or leu- 
cocytes, in accordance with their ancient 
role as digestants, attack, englobe and 
digest such foreign elements as mi- 
crobes, and also rid the system of de- 



284 



THE TRAINED NURSE AND HOSPITAL REVIEW 



composing cells and clear away effused 
blood, as in bruises, black eyes, etc. 

Behring next gave to the world his 
wonderful anti-toxins for tetanus (lock- 
jaw) and diphtheria. 

Pfeiffer advanced our knowledge of 
immunity by discovering that the blood 
juices themselves could dissolve some 
bacteria, and this threatened to give tlie 
death blow to Metchnikoff's ideas. 

When a disease-causing microbe in- 
vades the body of man complicated 
phenomena ensue, the whole process 
being conventionally looked upon in the 
nature of a conflict. On the one hand, 
offensive weapons brought into action 
by the microbe enable it to pass a phase 
of its existence before it again makes 
its exit from the body. On the other 
hand, the person attacked, or the host, 
by various defensive mechanisms seeks 
to protect its cellular units against the 
advancing microbes. 

Microbes seek to protect themselves 
by the elaboration of poisons. Poisons, 
then, are the weapons of offense. In 
certain diseases, as in diphtheria and 
lockjaw, the germs give off poisons 
which pass into the circulating blood, 
while the germs themselves remain at 
the point of inoculation. In other cases, 
and these are the more numerous, in- 
cluding nearly all other germs, the poi- 
sons are bound up in the microbes, and 
are only set free when a dissolution of 
the microbe takes place. This discovery 
we owe to Dr. Macfadyen, an eminent 
English bacteriologist, wtio, only a few 
weeks ago, became a martyr to his 
work, and died from having accidentaly 
inoculated himself in his laboratory 
with the germs of Malta fever. 

What is the defensive machinery elab- 
orated by the host as a response to in- 
fection by these microbes? Without 



some form of resistance the race of 
man, exposed as it is to multitudinous 
chances of infection, would be rapidly 
exterminated. Tlie degree to which this 
defence is called upon is subject to ex- 
traordinary variations in different infec- 
tions. In some cases it suffices ; in 
others it is totally inadequate, and the 
infected individual, beyond the range of 
therapeutic remedies, rapidly succumbs. 
From all we know, the mechanism of 
defence consists in the production of 
protective substances, which, entering 
the blood stream, are carried through- 
out the body. It suffices to know that 
these chemical protective substances can 
be demonstrated in the blood, and, fur- 
ther, it cannot be doubted they are 
created by the host. 

In certain diseases they act in such a 
way that an immunity is produced for 
a long period, or even for life. At other 
times the qualities and quantities are of 
low degree, the immunity being absent, 
insufficient or transient. Among the 
fundamental facts accepted in medicine 
at the present day, we know that immu- 
nity may be induced artificially, and if 
this is done prior to the infection the 
individual may escape w'hoUy and en- 
tirely from a disease which might other- 
wise prove fatal. 

This method was inaugurated by Jen- 
ner with smallpox, and continued by 
Pasteur, Behring and Wright in other 
diseases. 

Great as this principle of preventive 
inoculation is, it pales in importance be- 
fore methods which can bring about a 
cure after an infection has taken place. 

That such a thing is possible has been 
amply decided by the medical world in 
reference to the diphtheria anti-toxin 
of Behring and Kitasato. 

Apart from their work, the most re- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



285 



markab'le results from inoculation are 
those initiated by Koch in the case of 
tubercle and the recent work of Wright. 
The principles laid down by the latter 
investigator have opened up entirely 
new fields in the treatment of diseases, 
against which medical skill has practi- 
cally been powerless. 

The type of cases Wright has had to 
work upon may be described as the in- 
curable refuse of the hospitals, patients 
who had passed uncured from the re- 
splendent operating theatres to the Cim- 
merian obscurity of the out-patient 
dressers' departments. Before describ- 
ing to you the work of this genius who 
has revolutionized the treatment of so 
many diseases, you will be interested to 
know something of the man. 

His father Irish and his mother a 
Swede, educated in Dublin and . trans- 
planted at an early age to Australia and 
later to London, this is a concise de- 
scription of his early life history, con- 
taining factors so often present in the 
makeup of a genius — transplantation 
and mongrel blood. A master of lan- 
guages, the originator of a theory of 
belief, of a classical book on the micro- 
scope, and of eighty original medical 
communications, he was a glittering il- 
lustration of Longfellow's lines: 

The heights by great men reached and kept, 
Were not attained by sudden flight; 

But they, while their companions slept, 
Were toiling upward in the night. 

Working at his consultant practice 
in the morning and coming. to his labor- 
atory after lunch, he continued his in- 
vestigations till the early morning hours. 
His assistants he expects to do the 
same, and some are occasionally found 
by the laboratory attendant the next 
day, having fallen off their stools, asleep 
on the floor. 



It would have been enough glory to 
one man to have found a means by 
which any infant might digest almost 
any milk. Wright, by the simple addi- 
tion of appropriate quantities of citrate 
of soda to milk, found that curds were 
entirely prevented, and that an infant 
could digest easily what previously had 
been a poison. 

Preventive inoculation of some 300,- 
000 of the troops going to South Africa 
during the late war by methods he ori- 
ginated resulted in the occurrence of 
typhoid among those so inoculated in 
only half the proportion of those unin- 
oculated, and also these inoculations re- 
duced the mortality of the disease by 
one-half in those inoculated who be- 
came infected. 

Most of his remarkable discoveries 
have been made by his adaptation of 
glass blowing to suit his ideas and tech- 
nique. In this country he might almost 
be named the "Wizard of the Pipette," 
pipettes being the ingenious forms of 
glass tubes he has devised for his work. 

The technique he has developed for 
the work I shall try to describe to vou 
is ingenious, elaborate and difficult, and 
yet the most veritable tyro can get good 
results. 

Wright tells the story of a gentleman 
from this side of the water coming in to 
view the clinic, who asked if he might 
learn his technic. ''Certainly," said 
Wright. "How long can you spend 
here?" "Well," replied the visiting doc- 
tor, "not long, I'm afraid my wife is 
waiting outside in a cab." 

Wright and his co-worker, Douglas, 
a few years ago, found the connecting 
link to the ideasC'of Metchnikoff I have 
already spoken of. Remember Metch- 
nikoff stuck to Miis theory for fifteen 
years, but could not prove it. 



286 



THE TRAINED NURSE AND HOSPITAL REVIEW 



They found that the white blood cor- 
puscles did devour germs, provided 
these germs were first acted on by the 
blood juices. 

Adding white blood cells to an emul- 
sion of germs in salt solution, and ex- 
amining under the microscope, they 
found the white blood cells and germs 
lying alongside each other, but no 
germs inside the white blood cells. 

If they, however, took some blood 
juice, added this to the germs and then 
added the white blood cells, examina- 
tion under the microscope revealed the 
white blood cells to be crowded full 
with germs. 

They concluded, therefore, that there 
must be present a substance in the 
blood juices which first acted on bacte- 
ria, and prepared them for the appetite 
of the white blood cells. This substance 
they named "opsonin," from the Latin 
opsono, meaning: I prepare food for 
table. 

The leucocytes or white blood cells 
have often been spoken of as scaven- 
gers, and so they are, though unlike 
most scavengers, they must have their 
prey cooked for them. 

A natural result of this di.*<covery was 
that they could find out how many 
germs the white blood cells of a healthy 
man could devour after action of lis 
blood juices, and compare this with the 
number a sick man could prepare for 
his white blood cells. This ratio they 
called the opsonic index, and you will 
in future be as familiar with the term 
"opsonic index" as you are to-day with 



such medical expressions as uric acid, 
albumin and tubercle bacilli. 

Wright and Douglas next naturally 
tried to find out how they could increase 
the opsonins in sick people, and thereby 
cause the white blood cells to take up 
more germs, and so bring about a cure 
of their diseases. 

I will briefly explain here differences 
in behaviors of different microbes. 

Many of you have had your blood 
tested for typhoid, and you have had ex- 
plained to you by your physicians that 
if a drop of blood of a normal man is 
added to a drop of water in which ty- 
phoid germs arc swimming around, en- 
joying life like tadpoles, these germs 
take no notice of the addition. But 
should there be added a drop of blood 
of a man developing typhoid, these same 
microbes will stop their sport and imme- 
diately bunch together in a mass. This 
bunching or clumping is due to the de- 
velopment in the patient attacked by ty- 
phoid of protective substances which 
cause this clumping in order that the 
white blood cells can catch hold of them 
wholesale. To a very slight extent, our 
blood will cause tubercle bacilli also to 
clump together when we are attacked, 
but, unfortunately, we can develop no 
such protective substance against any 
other germ that attacks us. 

It is necessary, of course, for these 
clumps to be opsonized ; that is to say, 
acted upon by the blood juices, before 
the white blood cells will eat them, even 
though they are bunched. 



{To be continued.) 



9ln 5anort!)oliojc Opinion on S^egisitration 



CHARLOTTE A. AIKENS. 



/^ NE of the latest, most misleading 
^^ and unjust attacks on graduate 
nurses in general, be they ardent, active 
registrationists or not, has come to my 
attention through the following, which 
appeared as a news item in a weekly 
medical journal : 

"The Physicians' National Board of 
Regents for Commissioning Nurses, 
with headquarters in Philadelphia, is 
sending circulars to doctors throughout 
the United States advocating a reform 
in commissioning nurses. The circulars 
say, in part : 

"There is a growing tendency on the 
part of certain nurses to assume the 
functions of the physician in the sick 
room. Tliey are getting the idea they 
are to be doctors instead of nurses. 
Moreover, they want to charge a mini- 
mum rate of $25 to $35 a week, and they 
hope ultimately to secure legislation 
which will enable them to exclude the 
nurse who will serve for $5 to $12 a 
week and to compel the physician to 
employ only such nurses as are licensed 
under State laws, 

"This efifort is bringing discredit on a 
noble and useful occupation ; imposing 
financial burdens upon people of mod- 
erate means which they are unable to 
bear, and introducing into a sick room 
a principle which is not only dangerous 
to the patient but humiliating to the 
physician. It is therefore becoming 
necessary for the medical profession to 
regulate the business of nursing. State 
registration,' which practically means 
that the nurse shall have the same au- 
thority in the sick room as the doctor, 



cannot be tolerated. And the nurse 
who has the skill and willingness to carry 
out the doctor's orders must not be in- 
terfered with, no matter how or where 
she gained her knowledge. 

"In response to requests of leading 
physicians of the country, and in ac- 
cordance with the action of many medi- 
cal societies, the Physicians' National 
Board of Regents for Commissioning 
Nurses has been organized. The plan 
is to classify and commission all nurses 
who are duly qualified and are willing 
to abide by the instructions of the at- 
tending physician and not attempt to 
play the role of doctor." 

However much one may regret some 
existing conditions and tendencies in 
nursing affairs, no true nurse can read 
such statements as "That there is a 
growing tendency on the part of certain 
nurses to assume the functions of the 
physician in the sick room. They are 
getting the idea they are to be doctors 
instead of nurses," or that "State regis- 
tration practically means that the nurses 
shall have the same authority in the sick 
room as the doctor" — no true nurse can 
regard such statements in any other 
light than as a libel against the whole 
nursing body. However much divided 
we may be regarding some questions, 
we are surely united on at least a few 
points — that there is a distinct line of 
demarcation between the duties of the 
physician and nurse ; that her business 
is neither to diagnose disease nor to pre- 
scribe remedies ; that she is always, when 
on duty in the sick room, under orders ; 
that she is never, except in circum- 



288 



THE TRAINED NURSE AND HOSPITAL REVIEW 



stances of grave emergency, when no 
physician is available, to assume respon- 
sibilities that belong to the physician. 
We admit that there are nurses who 
have been indiscreet. We admit that 
mistakes have been made, not because 
nurses had not been taught better, but 
because they lacked good sense and 
judgment. 

There never was a fold of any size in 
which black sheep were not found, and 
it would seem only fair for every medi- 
cal editor who, unwittingly or other- 
wise, published such a statement to look 
up the facts and pubhsh both sides, so 
that medical readers might know what 
State registration does mean. 

My own opinion regarding registra- 
tion is that nurses have never empha- 
sized half strongly enough the matter 
of simple justice when pressing their 
claims for registration, and that they 
have emphasized altogether too strong- 
ly the improvements they intended to 
bring about in the training schools, and 
what hospitals would have to do when 
registration came to pass, in order that 
the standards might be elevated. The 
average man, be he British or American, 
is not profoundly interested in the 
height of the standards for nurses, but 
take him all around he treats women 
fairly decently and respectfully if they 
conduct themselves properly, and he 
usually has a fairly strong sense of jus- 
tice. The average man doesn't relish be- 
ing bossed around by women, but, on 
the whole, he is willing for them to have 
fair play. He may need tactful educat- 
ing along some points as to what jus- 
tice is, but with all his faults this aver- 
age American man appreciates hosrital 
trained nurses when he knows anything 



about them, and he can be influenced 
by the claims of justice in most cases. 

The rank and file of those who are 
particularly interested in the registra- 
tion question, outside of the nurses 
themselves, is made up of physicians, 
hospital superintendents and boards of 
managers. My experience with and ob- 
servations concerning a considerable 
number of these people is that most of 
them are reasonable people, inclined to 
be fair to nurses; not antagonistic to 
registration, but they do object to a 
great many of the methods that have 
been used to secure it and enforce it ; 
they decidedly object to the exact form 
which the registration bill has taken in 
a great many cases; they do object to 
the attempt to draw tight lines around 
training schools that mean useless and 
unnecessary burdens on them, and the 
pupil nurses; they do object to being 
continually dictated to by outside people 
as to what they must do in hospitals, 
and they do not agree in general with 
the registration sentiments which have 
been expressed that the educational 
work of the hospital is of equal impor- 
tance with the care of the sick. They 
are inclined to regard the care of the 
sick as their supreme duty, a responsibil- 
ity which they have assumed, and which 
may not be set aside in order to experi- 
ment with this or that theory, however 
beautiful and elevated that theory may 
be. 

This feeUng exists not alone among 
the classes mentioned, but it is shared 
in a large degree by nurses themselves. 
Of the eighty thousand nurses of the 
United States, a comparatively small 
number have openly expressed them- 
selves concerning these questions. A 
great many of them are afraid to 



THE TRAINED NURSE AND HOSPITAL REVIEW 



289 



"speak out in meeting," or write an ar- 
ticle for publication, for fear they will 
be promptly annihilated or mercilessly 
scored as having "low standards." For 
my own part, I prefer to have people 
say I have "low standards" rather than 
have them say I have high ideals but 
am utterly impractical and lacking in 
common sense. And that is exactly 
what a lot of people are saying about 
some idealists. To be perfectly candid, I 
prefer to stay with the comon people 
and to help them to get the sick proper- 
ly cared for somehow, rather than to 
live too far above them, too far in ad- 
vance of the times, and ignore present 
conditions and pressing needs. And I 
am one of a fairly large and highly re- 
spectable company, even though they 
do not all come out and publicly ex- 
press their sentiments. 

"Is she sound on registration?" is a 
burning question among nurses in these 
days, and in order that I may not be 
entirely misunderstood, I will adopt the 
Methodist plan and relate my experi- 
ence. My attitude toward the doctrine 
of registration was first of all one of in- 
difference, then absolute antagonism, 
because of the dictatorial methods as- 
sumed by some of its active promoters, 
then finally absolute surrender to the 
idea of registration in spite of what 
other people did or said, because I could 
see that the principle was absolutely 
just. I have never felt that the talis- 
manic letters R.N. would add to or sub- 
tract one iota from my own personal 
success, financially, socially, profession- 
ally or in any other way. But I realized 
that it might have some eflFe'cts in the 
case of my own nurses, and for their 
sakes, as a matter of simple justice to 
them and others like them in spirit, I 



believed in it. I felt that the hospital 
trained nurses who had given of their 
best service loyally and without stint for 
a space of two years, keeping their long, 
weary vigils night after night, always 
ready for duty in time of emergency, 
getting through it all as thorough teach- 
ing and training as I was able to give 
them and secure for them — I felt that 
this class of nurses deserved some pro- 
tective mark that would distinguish 
them from the great army of rejected 
probationers, correspondence and short 
course nurses, as well as totally un- 
trained women who had assumed the 
name "trained nurse." That was the 
conviction that led to my conversion to 
registration. I may not be "sound" on 
it, but I still believe that. This convic- 
tion was strengthened by some personal 
experiences with the- spurious brand of 
trained nurses. 

Justice to the nurses who have stood 
by me so loyally through years of stren- 
uous hospital life demands that they be 
given some badge of distinction from the 
classes of women I have mentioned. I 
have never believed that registration 
would accomplish one-quarter of what 
some others seemed to beheve it would. 
I have never believed that in order to 
get this distinctive mark it was at all 
necessary to try to get laws passed that 
would embarrass hospitals. I have never 
believed legislation was the thing that 
was going to right all wrongs and re- 
form the hospitals and make them per- 
fect abodes for the aspiring, highly edu- 
cated young women of the twentieth 
century, who might flock to them for 
training. Nor, in truth, have I ever been 
fully convinced that such work is the 
business of hospital graduates. Maybe 
it is. Probably they might improve some 



290 



THE TRAINED NURSE AND HOSPITAL REVIEW 



things if they went at it in the right way, 
but they could accompHsh this in most 
cases without registration. If a hospital 
is not feeding its nurses as it ought, the 
graduates of that hospital might tactful- 
ly approach the superintendent and man- 
agers and call attention to the fact with- 
out being registered or having State 
authority to do so. 

I suppose I have not the proper nur^e 
spirit, but I have never sympathized 
with the attacks that have been made on 
what is termed the "lay nursing press." 
I would be perfectly satisfied to have 
even Everybody's Magazine or Tlie 
Scientific American publish articles by 
nurses for nurses and about nurses and 
nursing, and I would encourage people 
to buy the magazine. 

So long as it is a good magazine, pub- 
lishes sound, practical, profitable ma- 
terial, and is doing a useful work, I care 
not a whit whether its editor is male or 
female, or has taken a nursing course or 
not. I want nurses and everybody else 
to have fair play, including "the lay 
press." There is room for all the good 
journals that we have, and perhaps a 
few more, though I do not know that 
additional journals are badly needed. 
The "lay nursing press," so far as I have 
been able to ascertain, has approved of 
registration principles, without endors- 
ing a great many of the methods that 
have been pursued, but there is no 
crving need for all magazines to be 
harping away on the same string con- 
tinually. 

There is no need to lose sight of the 
many other important questions relat- 
ing to practical nursing and the nursing 
field because one believes in registra- 
tion. Tliere is need that some journals 
should make the attempt to see all 



sides of the registration question and 
try to preserve the balance. There is 
need that some journals should make 
a business of trying to promote amica- 
t)le relations between nurses and phy- 
sicians, and to prevent misunderstand- 
ings between these two great bodies so 
closely related and mutually dependent. 
There is need for a broad, fearless, inde- 
pendent journal in nursing affairs, just 
as there is in medical and religious and 
other lines of thought. No journal can 
claim a monopoly of all truth and wis- 
dom. In free America there will always 
be a goodly proportion of people, nurses 
included, who will reserve the right to do 
their own thinking, and who will refuse 
to be coerced into endorsing methods 
and principles of which they do not ap- 
prove. There are doubtless a good many 
more of that class of nurses than have 
ever stood up to be counted, if the test 
were put. In fact, the opinion of the 
large majority of the nursing body has 
never been secured. 

One of the things which has helped to 
effectually kill enthusiasm for registra- 
tion has been the tendency to run to ex- 
tremes regarding training. There has 
always been thrust at nurses a great 
deal tnore medical knowledge than they 
needed, but since registration has come 
to pass this tendency has been increased, 
and list after list of topics for lectures on 
purely medical subjects has been pre- 
pared and ])lanned for. till it has become 
an absolute burden to both the pupil 
nurse and the hospital, with no possible- 
benefit to be derived from a great deal 
of it. There is one test which I should 
like to see applied to every lecture, and 
every plan for a class on any nursing 
subject. It is this: "What am I going 
to teach? Will the nurse be any better 



THE TRAINED NURSE AND HOSPITAL REVIEW 



291 



fitted to take care of John Smith after 
she has had this lesson than if she had 
never gotten it?" It seems to me that 
test, if conscientiously used, would re- 
duce the burdens at least one half, and 
in some schools a great deal more than 
that. 

Another feature of registration that 
seems most unjust, both to the pupil 
nurse and the hospital, is the three-year 
ruling. There are hundreds of small 
hospitals that can give a nurse a good 
general experience — a training that will 
make her resourceful and capable, but 
they cannot make the third year profit- 
able to the pupil nurse. Tong before 
the end of the second year she gets 
weary of the monotony. If she has to 
stay a third year she feels it is for the 
benefit of the hospital, and she chafes 
under the conditions^ Hospitals cannot 
force aflfiliation any more than people 
can force other people to associate with 
them, so the small hospital, under this 
unjust ruling, is forced to attempt the 
impossible, often to its own embarrass- 
ment and detriment. Numbers of prom- 
ising candidates who would enter for a 
moderate course of two years, stay out 
and take the short cut to the nursing 
field via the correspondence route, or 
by similar ways, and the promoters of 
these schools are the people who arc 
-doing more harm to the registration 
cause to-day than any other. They are 
helped by the impossible standards 
wliich registration has brought about, 
though they violently oppose any dis- 
tinctive mark. The average hospital 
needed no legislation to induce it to give 
a three-year course. It soon found it 
was to its advantage to do so, if it could 
get nurses to enter, and it needs no leg- 
islation to keep to the three-year course 



if enough candidates can be induced to 
take it. It is one thing to give a three- 
year course, because it seems to be a 
good thing for all concerned, but it is 
another and a very different matter to 
be compelled by law to give a three- 
year course when you already have diflfi- 
culty in getting enough nurses to enter 
for two years. 

Another feature that has seemed both 
unwise and unjust is the high school 
education test for entrance to training 
schools or for registration. In a recent 
conversation with a hospital superin- 
tendent as to the proportion of her 
nurses who were high school graduates 
or who would be able to pass an exami- 
nation before an accredited high school 
principal showing that the candidate 
had an education equivalent to high 
school entrance (at least ■ one State 
board now requires this), she said she 
doubted if one of her nurses could pass 
such a test. Yet she said they were, 
with one or two exceptions, capable and 
faithful and trustworthy and satisfac- 
tory, and a neater, more attractive, class 
of nurses I have never seen. 

Another said that even ten years ago, 
when nursing candidates were far more 
plentiful proportionately than they are 
to-day, she could not have risked putting 
such a test without seriously crippling 
the hospital, and she had very little 
chance for any choice at all among ap- 
plicants to-day. I have quoted else- 
where and I now quote again the state- 
ment made by a prominent social work- 
er who had investigated conditions : 

"It is an indisputable fact that about 
90 per cent, of the pupils in the public 
schools leave before the high school 
stage. Perhaps two-thirds of this num- 
ber fail to complete the grammar 



292 



THE TRAINED NURSE AND HOSPITAL REVIEW 



grades." Another prominent educator, 
writing on the necessity of improviner 
rural schools, stated that less than five 
per cent, of the pupils in rural districts 
get any education other than that re- 
ceived at the rural school. These are 
the conditions which exist out in the 
world from which the supply of nurse 
candidates must come, and yet, either in 
utter ignorance of these conditions, or 
in defiance of them, nurses have framed 
bills that virtually restrict the source 
from which hospitals may consider ap- 
plications to their schools to less than lo 
per cent, of the population. One does 
not need to be very far-sighted to be 
able to detect signs of a coming storm 
in a great many registration States. The 
wise thing would be for nurses to 
promptly acknowledge that they have 
made a mistake in ignoring these con- 
ditions, and themselves modify such en- 
actments. 

We have at the present time this in- 
congruous situation : A nurse can be 
registered in New York State without 
putting in a day's duty in a hospital if 
she can satisfy the examining board that 
she knows how to nurse. She can grad- 
uate from any one of several large hos- 
pitals (and the number grows apace) — 
hospitals having two hundred beds and 
upward — in two years, and be regis- 
tered forthwith ; but in most States, 
where the standards have been fixed at 
an ideal height, she must spend three 
years in a hospital, even if it has only 
thirty beds, and she has served in every 
department of it inside the first six 
months. No matter how proficient and 
capable she may be at the end of two 
years, she must stay on in the hospital 
another whole year, or the hospital will 
not be recognized as a training school. 



These are some of the conditions which 
make one pause and wonder whether 
registration is really a blessing or a 
nuisance, and a detriment to both hos- 
pitals and nurses. Perhaps it is a mix- 
ture of all three. Still, I believe in the 
justice of the principle of registration if 
we could avoid these extremes. In some 
States this has happily been accom- 
plished. 

In some of the Canadian provinces 
there is a law that a medical graduate 
cannot be registered or licensed until 
he has spent a year either in a hospital 
or in association with an experienced 
physician. One year after he graduates 
he comes back for his provincial exami- 
nation. It seems as though some such 
regulation might be better than these 
unjust conditions that prevail. If this 
additional year is -an absolute necessity 
in the interest of public safety before a 
nurse can be registered, it does seem 
that a nurse, especially those from the 
smaller hospitals, might be allowed to 
spend that year in getting a different 
kind of experience under a physician's 
supervision, and also in adding to her 
income, rather than be compelled, be- 
cause of a law of this kind, to go, day 
after day, the monotonous round in the 
very same wards, doing the very same 
kind of duties she did in the first six 
months. She would have an incentive 
to keep up her studies, and she would 
have the three years' experience. The 
handicaps that are crippling so many 
hospitals would be removed, and she 
would have some money in her pocket. 

This, of course, is an unorthodox 
view, and I know it, but I believe that 
in a free country the unorthodox folk 
ought to get a hearing once in a while, 
even on the registration question. 



CJje aDbantages of Craining jaurses in if amilies' 



MRS. L. D. PALMER, FRAMINGHAM, MASS. 



SICKNESS in all its phases and de- 
grees is a serious thing in famil>' 
life, and the nurse who comes in to take 
the burden of the care of the patient 
should be hailed as a comfort and de- 
light — as a friend, indeed. It is thus a 
self-evident proposition that she should 
add as httle as possible to the family 
cares. 

The two extremes in the care of the 
sick are the old-time nurse and the one 
with a hospital training. 

There are advantages in both; each 
has its objections. 

The untrained nurse made herself very 
useful, and was expected to do many 
things now disowned by the profession. 
She washed and ironed for her patient, 
served, and even, in some cases, did the 
general housework, oftentimes finding 
leisure to do these things because she 
did not know how to better employ her 
time in behalf of her patient. 

I have a soft spot in my heart for an 
untrained nurse who cared for me some 
twenty years since, when the profes- 
sional nurse was an almost unknown 
quantity in country towns. 

She was possessed of excellent judg- 
ment, tact, a cheerful disposition and the 
faculty of anticipating the patient's 
wants. 

She did for me what the physician di- 
rected, and, at the same time, helped in 
many little things about the family du- ■ 
ties. 

That kind of woman would make a 
place for herself anywhere, whether hav- 
ing a technical education or not — she 



• Read at the meeting of the New England 
trlbutcd to The Trained Nurse. 



was in constant training of head and 
hand. 

My next-door neighbor sent to the 
city for a hospital nurse to attend her in 
confinement. 

This nurse knew the technique of her 
profession well, and in an emergency 
rose to meet it, but she was an entire 
contrast to the above-mentioned willing 
worker. 

Her favorite occupation was reading 
Browning aloud on all occasions, and 
this she insisted upon doing when the 
patient was nervous and the baby fussy, 
and. regardless of needed attention to 
both. 

The cook was upset by her, and the 
second girl snubbed, while things gen- 
erally went awry, so that the whole fam- 
ily were glad to dispense with her ser- 
vices at the earliest possible moment. 

You may say that these were ex- 
treme cases, and due largely to differ- 
ences in temperament. Granted. But 
is not the popular notion that a trained 
nurse upsets the family life founded 
upon a grain of fact? Have we not all 
seen cases where the nurse made more 
work for the family than the care of the 
patient entailed? 

Do not misunderstand me. I consider 
many a trained nurse of the greatest as- 
sistance and comfort, and would not be- 
little her offices in the least, but they are 
not all alike. 

For the nurse who intends to do insti- 
tutional work there is no question the 
training obtained in the hospital is an 
absolute necessity. She must be familiar 

Association for the Education of Nurses, and oon- 



294 



THE TRAINED NURSE AND HOSPITAL REVIEW 



not only with* sickness in its varied 
forms, but also with appliances, instru- 
ments, etc., and also with the customs 
which have become an important part of 
that life. 

My remarks do not apply to this class. 
But the large majority of graduate 
nurses expect to do private nursing, to 
be in an entirely different atmosphere, to 
come into contact with anxious parents 
and nervous friends, not only during a 
brief visit to the sick-room, but by day 
and night, and to come into and become 
a part of the family life for the time 
being. 

Such being the situation, should we 
noj; expect to reap an advantage from 
training our pupils in surroundings sim- 
ilar to their future fields of work? 

Of course, no one thinks of educating 
nurses in these days without some hos- 
pital experience. 

In our school at Framingham we 
spend two years of the three under the 
hospital roof. The nurse has about one 
year before she is allowed to go out at 
all. this time is spent in the laboratory 
kitchen, where all the food served the 
patients is cooked ; in the wards, and in 
the lecture room, much the same as in 
most hospitals. 

When the nurse shows herself suffi- 
ciently proficient in her art, she is al- 
lowed to go out on a case. During the 
junior year this must he in town, so that 
she may come in to lectures each day, 
and must be a case under the care of a 
physician who is one of the instructors 
in the school. • 

As she comes in each day, she has an 
opportunity to talk over her difficulties 
with her teachers, and to ask advice 
needed on any point. The physician be- 
ing a member of the faculty can also 



make such extra report as he thinks 
best, aside from that which comes from 
the family upon the regular blank. 

Tlie nurse is here thrown upon her 
own resources much more than in the 
hospital. She also learns to give the 
most accurate attention to the attending 
physician's directions. 

An eminent Boston physician in ad- 
dressing a class of nurses about to grad- 
uate told them that it was of the utmost 
importance that they should get in touch 
with the families of their patients ; that 
they should learn their idiosyncrasies, 
habits and customs and respect them, no 
matter how foolish these might seem. 

Training in families is a long step 
toward establishing these relations, and 
being experienced during the formative 
period, it tends to give tact and insight 
into character, while it rubs off many a 
sharp corner of stiff professional dig- 
nity. 

To be cared for iiT a hospital by a 
trained nurse is the luxury of sickness, 
if I may use the term. There expense 
is hardly reckoned ; instruments, appli- 
ances and materials all are at hand. 

How is it when a nurse goes into a 
family? 

G. Stanley Hall has said that when he 
wished an assistant he did not go to the 
colleges and technical schools, but pre- 
ferred a young man from the country, 
possibly brought up on a farm, where 
he may have had to use his ingenuity in 
improvising makeshifts, or where he 
niay have had to do without, but, most 
of all, where he must do his own think- 
ing. Thomas Edison, in a recent utter- 
ance, has expressed something the same 
opinion. 

When the nurse goes into a family 
she finds that utensils so familiar in the 



THE TRAINED NURSE AND HOSPITAL REVIEW 



295 



hospital- are lacking, in some cases arc 
beyond reach from lack of time to pro- 
cure them ; in others their purchase is a 
pecuniary burden to a family already in 
distress from the calamity of sickness. 
What is to be done? The mind must be 
set to work and all the latest resources 
brought out to do the next best thing. 
On the other hand, how often does a 
nurse, coming from a humble home, find 
herself in luxurious surroundings, with 
no experience in caring for the same. 
Many a nurse, well taught, has ruined a 
finely polished surface because she was 
nervous and flustered by the unfamiliar 
air of things, doing what she never 
would have done had she had her train- 
ing on the spot. 

You may say that people of means 
will not employ student nurses, but that 
is not true. A man who is well-to-do 
usually is so because he has not wasted 
his money, and a dollar is a dollar to 
rich as well as poor; in fact, those hav- 
ing means often seem to be less ashamed 
to economize than those without. Stu- 
dent nurses are used by all classes wher- 
ever the sickness is not too serious, and 
during the senior year the nurse is ca- 
pable of undertaking even critical cases. 
In the hospital ward obedience is the 
watchword. Do as you are told, asking 
no questions. Your superiors are at 
hand to decide every point in any emer- 
gency. And it is necessarily so. The 
delicate wheels must be kept in accurate 
adjustment, or the whole great machine 
fails to do its work. There is no oppor- 
tunity for individuality here. 

But the personal traits will count 
largely in the future success of a nurse, 
and she whose favorable characteristics 
are best developed has the best chance 
in life. This, we claim, is one of the re- 



sults of training in families, district 
nursing being one of the most helpful 
branches of that service. 

One important point is that this 
course shows the pupils their deficien- 
cies. 

There is no time when a teacher tries 
so hard to get at the bottom facts in a 
problem as when he knows he must 
teach them to another. 

The acquirement of knowledge takes 
on a new form when it ceases to be a set 
task and becomes a necessity. So with 
the pupil nurse. There is no time when 
she so appreciates the instruction given 
her or absorbs knowledge with more 
avidity than when she returns to the 
hospital (after a course in family nurs- 
ing) and there takes her final instruc- 
tion. 

The nurses themselves take great 
pride in being sent out to cases. They 
consider it an endorsement of their ef- 
forts to perfect themselves as rapidly as 
possible, and they will strain -^very nerve 
to do their work in a manner satisfac- 
tory to the family and to their instruc- 
tors. 

No one can deny that there are diffi- 
culties in this method, but they are off- 
set by the better results. Nurses who 
do not prove themselves reliable have to 
be weeded out; they have no place in 
this profession, which holds alike the 
lives and characters of men in their 
hands. But the vast majojity are bene- 
fited by the trust placed upon them. 

Student government and the honor 
system work equally well in olleges and 
in training schools for nurses. 

So far we have considered this ques- 
tion from the standpoint of the nurse 
only, but there are two other phases W2 
should consider. 



2% 



THE TRAINED NURSE AND HOSPITAL REVIEW 



The large majority of families do not 
feel that they can pay $3 or more per 
day for a nurse in cases of slight illness. 
By employing a pupil nurse they obtain 
at a less price some one competent to 
care for cases of that description, and 
who, if the patient's sickness should 
prove serious, can be exchanged with- 
out breaking any hearts, for a nurse of 
more experience. 

The people of our town would feel 
themselves much abused should the 
privilege of employing student nurses 
be taken from them. 

Secondly, the pecuniary gain to the 
school is not to be despised. 

I am well aware that I am treading 
on dangerous ground when 1 mention 
remuneration for services thus rendered, 
but I can see no reason for not receiv- 
ing the same, provided the work has 
been done as the same work in the hos- 
pital would be, to instruct the nurse and 
give aid to the sick. 

That there should be any ethical rea- 
son why it is not right and proper for 
a nurse to pay for her education by her 
labor I cannot comprehend. Why 
should patients in the hospital be ex- 
pected to pay for the care given by 
student nurses if private families should 
not for work of the same kind.'' 

In our school the treasury has, up to 
a very recent date, been entirely sep- 
arate from that of the hospital. 

The funds earned by the nurses have 
been used entirely for the board and 
education of the pupils of the school. 
Although there have been the closest of 
relations, the two institutions have been 
entirely separate, thus preventing the 
charities of a hospital with small en- 
dowment from draining the family purse 



and dwarfing the education, of our 
nurses. 

We have been self-supporting for 
many years and have had no endow- 
ment whatever to draw from. 

As we received practically nothing for 
our nurses in the hospital, the outside 
work has been our main stay, not only 
giving us money for their services, but 
providing meals in most cases as well. 

In the smaller cities it id often im- 
possible to support a training school 
otherwise. In our own case, the school 
has made the ho.spital and both have 
been of the greatest service to the town 
and its vicinity, and without work in 
families neither would have existed. I 
can but feel that ;he over-trained nurse 
is in the same condition as the Southern 
labor problem seems. 

The whites are making bitter com- 
plaint against the education of the col- 
ored people, because the latter decline 
to work with their hands as soon as 
they get a taste of book knowledge. If 
the nurse, for any reason, does not do 
all she can for the family she takes the 
attitude of the negro and loses a god- 
given privilege to be of use to her 
fellow men. 

Only a few years since men were 
thinking that only the hterary or pro- 
fessional life was really honorable, but 
the reaction has already come. Now 
they are rushing into business, and even 
farming, long looked upon as fit for 
clods only, has become an employment 
into which a man of intelligence may 
put the best eflfoit of both brain and 
muscle. 

The women of to-day are going 
through the same process. New ave- 
nues of labor are constantly opening to 
their demands, housework is fast com- 



THE TRAINED NURSE AND HOSPITAL REVIEW 



297 



ing to take its proper place and we are 
coming to realize that no work is me- 
nial unless perfonned in the spirit of a 
menial. She who puts her heart, her 
best energies and her brains into her 
work need never fear any kind of em- 
ployment. 

So it will be with nursing One who 
. loves humanity need have no fear of in- 



juring her professional dignity. She 
but gains additional honor by her de- 
votion to her patients and those con- 
nected with them, and by being willing 
to serve in ways that give comfort and 
joy to those dependent upon her for 
care. And to this home nursing we at- 
tribute much that is best In the develop- 
ment of her character and profession. 



Alleviate Post-Operative Discomfort 



The alleviation of discomforts of a pa- 
tient after an abdominal operation per- 
formed under ether anesthesia may be : 

1. Vomiting: in which case the patient 
should not have anything by mouth. 

2. Nausea: often relieved by inhala- 
tion of vinegar from a cloth. 

3. Dryness of the tongue and lips, and 
thirst : moist compress to lips. Allow 
patient to rinse mouth frequently. 

4. Backache : (a) rub back, (b) small 
pillow to relieve pressure, (c) turn pa- 
tient slightly on side and support on 
pillows. 

5. Numbness of limbs: (a) massage, 
(b) elevate knees on pillows. 

6. Pains: 

(i) Pains in head, (a) ice cap, (b) 
massage. 

(2) Pain in abdomen due to: (a) 
gas, which may be relieved by 
hot water bottle, (b) Distended 
bladder, hot water bottle over 
bladder; hot perineal stupes; 
catheterization, (c) Wound in 
abdominal wall; lighten binder, 
(d) Operation upon viscera; 
heat, (e) Pain in chest due to 
pleurisv or pneumonia; pneu- 
monia jacket; ice cap; room 
temperature, 65 to 68 deg. F. 



7. Irritation : 

(i) Skin : from discharges as bile, 
pus, urine, etc.; cleanliness. 
Ointments : lanolin, zinc oxide, 
boric. 

(2) Irritation of nose and throat: 
keep air warm and moist; lini- 
ment, as camphorated oil. 

(3) Irritation of eye: dark room; 
ice compresses. 

8. Sore mouth and tongue due to 
mouth gag or tongue forceps : mouth 
wash of listerine, 1-8. 

9. Sore lips (herpes) : vaseline or cold 
cream. 

TO. Nervousness : 

(t) In alcoholics, massage. 

(2) Morphine fiends, massage. 

(3) Neurasthenia: fa) massage, (b) 
sympathy, (c) scolding. 

II. Faintness: 
(i) From loss of blood : (a) elevate 
foot of bed, (b) bandage legs 
and arms. 

(2) From pain : (a) hot water bottle, 
(b) ice. 

(3) From fright: (a) assurance, (b) 
cheerfulness, (c) sympathy. 
—Cleveland Medical Journal. 



^rofefifitonal ©^ligations; anli 3Recent Crittcifims 



CHARLOTTE MANDKVILLK PERRY. 
Siiperiutendent of Nurses, Faxtou Hospital, Utk-a. N'. Y. 



T N watching any great movement such 
-*• as that going on within our experi- 
ence in the nursing world, it is well to 
keep steadily in mind the underlying 
principles and our attitude toward 
prominent features of the case Be- 
cause moral obligation is so a part of 
nursing, we are specially called to a 
patient study of the evolution of the 
movement. Of two things we may be 
certain — that such signs of progress, so 
widespread, so stirring, are bound to be 
revolutionary in character, and that rad- 
ical progress must necessarily be slow. 
There is the greatest demand for tact 
in instituting changes, establishing legal 
provisions, and in guarding against per- 
sonal interests. A good leader will en- 
courage the esprit de corp, and strive 
for the interests of the professional 
body as a whole, even giving up pet 
schemes and theories, for which the 
time is unready. It is helpful to watch 
the growth of other bodies like the edu- 
cational and the industrial, v^hich repre- 
sent two. factors in nursing. 

The medical profession, to which we 
are so closely allied, can give us from its 
rich experience. For this and for more 
apparent reasons, such as the relation 
of doctor and nurse to the patient, it 
will be a misfortune if prejudices sep- 
arate us. Our obligations to each other 
and to those with whom we are asso- 
ciated for good or ill should rather pro- 
vide a motive fo;* harmonious action. 
Rivalries between hospitals or indi- 
viduals are worse than provincial ; they 
absolutely hinder progress. There are 



other things which obscure the field, 
such as exaggerating a reaction in any 
State, or the conservatism of some 
States, which are surely feeling their 
way, though beset with special prob- 
lems. It should be rememiered that 
standardization is a most diflFicult 
process. In the p.ffiliation of schools, 
what would be considered a fair ex- 
change by one might utterly be refused 
by another, each side being influenced 
by a legitimate pride for it.s respective 
school, and seeing serious flaws and ob- 
jectionable teaching to which nurses 
well trained in those particulars must' 
be subjected. It nbove all other fac- 
tors must be one of slow growth, lef' 
to the heads of training schools, who 
alone are capable of judging. 

It must be noted as conmiendable that 
the effort made on the part of Boards of 
Examiners to adapt themselves to the 
standard of excellence which obtains in 
the various schools shows a good and 
fair judgment. This more than anything 
else has done much to quiet the fears of 
those who have looked upon the title 
R. N. as a sort of snare set to trap them 
at the end of three years' hard toil, to 
rob them of the right to practice their 
profession. Though it must be admitted 
that this is a .small view of registration, 
yet it is pardonable, considering the 
great responsibility involved on formu- 
lating State laws 'ind regulations. Some 
utterances may have given rise to the 
impression that coercion to a l.armful 
degree would be used, and some nurses 
mav have felt a certain self-sati^taction 



THE TRAINED NURSE AND HOSPITAL REVIEW 



299 



on finding that they wore not only not 
debarred from ^vhat they considered 
theirs by right of graduation, but had 
gained the encouragement of doctors 
who regarded these changes as disas- 
trous, and who thus have had something 
to do with their disaffection from the 
side of progress. There is another as- 
pect which is discouraging to those 
whose vision is large. It reveals the 
spirit of inertia, laissez faire, commer- 
cialism, fears, prejudice, self interest — 
all of which are impediments to any 
cause. Progress will depend largely on 
maintaining those true relations which 
should exist between the medical and 
nursing professions and the laity. The 
ethical principle is the keystone to our 
profession. We believe this principle to 
be identical with that of the medical 
profession, with its shining lights, Hip- 
pocrates, Galen, Harvey, etc. Wc, also, 
have our ideals, our leaders with whom 
rests the responsibility of not being 
swayed by political or personal motives. 
We give our confidence to those prime 
movers in that progress which has char- 
acterized the last twenty years. Should 
any one fail to hold fast to the true in- 
terests of the profession will not Time 
reveal the cloven foot? 

It is felt that in the main the move- 
ment has been in the right direction, 
and there is now no turr ing back. There 
are unmistakable signs of growth within 
to meet the demands in conditions which 
exist without. Struggles and mistakes 
are alike concomitants in such a devel- 
opment. While we bear in mind the 
relations between the two professions, 
and value the help and good faith of 
many physicians who have ctudied ths 
situation of to-day, and have given us 
their opinions in matters of grave delib- 



eration, it must be aclnowledgca that 
the superintendents of tram ng schools 
are the better judges in some things 
The length of the course is a relative 
(juestion. In those outlines of study and 
work (freely submitted to criticism) 
items so enumerated are often mis- 
leading. Many of the subjects are parts 
of a whole, especially in pra:tical teach- 
ing. The fact that our text book? cover 
no more ground, though thes' have been 
rearranged and improved in many ways, 
is proof that not much more is required. 
Only gross anatomy is taught. Simple 
Materia Medica, not Therapeutics, is 
more generally included in class worK, 
rather than left to the option of the pu- 
pil. Dietetics involves no more chemis- 
try than is taught in the puoiic schools, 
and this amount is necessary to a right 
understanding of the five food princi- 
ples. From her study of physiology, a 
nurse is prepared for dietetics, and there 
is no other subject so useful, practical 
and essential in her work of nursing. 

On the practical side the effort to se- 
cure good instructors, mature women of 
experience, who will carefuHv supervise 
and scrutinize the work of the pupil 
nurses, is highly commendable. No one 
will be more conscious of naeds and of 
failures than the superintendent of the 
training school who has herself had an 
all-around training. The Jiflucnce of 
the young nurse, who is often an under- 
graduate occupying the position of head 
nurse, is injured by the inexperience 
which she cannot help. Time must be 
allowed to acquire that most valual)le 
preparation. There is also a, los i on the 
jdisciplinary side. A leader must n?ver 
be known to have made a mistake, 
nor a teacher to have inculcated 
wrong knowledge. Experience, vigi- 



300 



THE TRAINED NURSE AND HOSPITAL REVIEW 



lance and decision are all required. The 
position of head nurse should be better 
recognized than it is to-day, uoth as to 
appointment and salary. This is truer 
still of instructors and supervisors. Con- 
sidering the difficulties in securing the 
doctor who lectures gratuitously at the 
end of a busy day, or amid pressing calls, 
or the regularly employed instructor, 
who cannot accept so small a stipend 
for so large an output of time and 
energy, allowance should be made for 
those drawing up the curriculum. With- 
out the collegiate system there is 
an element of uncertainty about the 
course of study and lectures, and of 
making use of the same, which is very 
wearing to the chief executive. But 
there are obstacles in establishirg this 
system. Many a good candidate who 
cannot aflford to pay may be able to 
work for her training. 

Apprenticeship is almost a necessary 
factor in a training school for nurses. 
Few will understand the difficult :es in- 
volved in this side of the qt^estion bet- 
ter than the heads of training schools. 
There was a time when fifteen dollars a 
month, shelter and board, with the train- 
ing for a profession which promised so- 
cial advantages and good remuneration, 
was very attractive to the coniii.ercial 



mind of the disqualified candidate. Those 
vvno have fought against the admission 
of such persons have been true to a 
noble cause, in this we have stood 
more or less alone, and have not always 
had support from the medical profes- 
sion, while at the same time, to be true 
to our standard of ethics, we have 
taught the principle of an allied profes- 
sion, of rendering a willing dependence. 
If among the body of graduate nurses 
there are some who do not uphold these 
principles, who after leaving the hospital 
diagnose, prescribe, undermine, influ- 
ence or overcharge, may it not be traced 
back to the co-operation gained ir "get- 
ting into the training school," or if a 
diploma was not granted, to being em- 
ployed on the same terms? There is no 
essential rivalry in the complet : auton- 
omy of both professions, althoug'h our 
interdependence should make us desire 
harmonious action for each. In Amer- 
ica, where among graduate nurses there 
is more self-direction, there is more 
good faith and comradery than in the 
old country, where doctors manage the 
aflfairs of nurses to a considerable ex- 
tent. Should not this attract attention? 
The establishment of pleasant relations 
doubtless leads to the solution of many 
problems and to mutual helpfulness. 



Hot Water 



The usefulness of local applications 
of hot water is well known. The gen- 
eral hot douche is a remarkable means 
to bring blood to the surface of the body, 
to accelerate the circulation, etc. Noth- 



ing is more cleansing than the moist 
vapor bath, since it cleans out the pores 
from within by the expelling force of 
hyper-secretion. — New York Medical 
Journal. 



msttttml jaursing in ^ribate practice 



PAPER I. 

Nurses' Duties Before and During Labor 

ANNIE B. HUTCHISON. 



THAT the knowledge of the mater- 
nity nurse should include much 
that she does not expect to have to put 
into practice ordinarily is certainly a 
necessity if she is to be fully capable of 
meeting the emergencies that so often 
arise in the private practice of her pro- 
fession. Without any inclination to en- 
croach upon the physician's province, 
with, very likely, a heartwhole desire to 
abide strictly within the limits of her own 
sphere, the private obstetrical nurse is, 
nevertheless, quite likely a- s .me time 
or other to find herself suddenly called 
upon to assume responsibilities that 
rightfully belong to the doctor, his ab- 
sence at a critical time leaving her no 
choice. While this is to a certam extent 
true of all nurses, it has a very special 
application to those who pactice their 
profession in the more remote districts, 
where, as the writer knows frcm past 
experiences, a private nurse not only 
has ample opportunity for the exercise 
of her own judgment, but may also be 
called upon to meet emergencies where- 
in, if the case is obstetrical, the welfare — 
perhaps the very life — of a mother or 
child, or both, may depend upon the 
nurse's ability to act coolly, promptly 
and skillfully. Whether or not a nurse 
may ever have occasion to assume great 
responsibility, to possess a good theo- 
retical knowledge of what ought to be 
done, should render her all the better an 
assistant to the doctor in any emer- 
gency, and the nurse's own common 



sense must decide when urgent need on 
the part of a patient calls upon her to 
allow theory to give place to practice. 

If engaged for a specific date ahead, 
the nurse will usually have an opportu- 
nity to make the acquaintance of her fu- 
ture patient, and at the same time have 
also the opportunity of advising her as 
to the provision it is desirable to make, 
an advantage thoroughly appreciated 
only by those who know what it is to be 
called to a case at the last moment when 
everything may probably be in confu- 
sion and most of the ordinary necessi- 
ties, not to mention conveniences, are 
conspicuous by their absence. The list 
of articles required to be furnished by 
the prospective patient in readiness for 
her illness varies much in style and 
length according to views and prefer- 
ences of different nurses; and, while 
every nurse naturally prefers to have all 
the luxurious conveniences as well as 
actual essentials, a nurse should in some 
cases be very careful to demand only 
what is really necessary to the welfare 
of her charges. It sometimes happens 
that people of very moderate or small 
means make considerable sacrifice in or- 
der to secure for an expectant mother 
the services of a skilled nurse and it 
also sometimes happens that they arc 
thoroughly dismayed by the elaborate 
list — copied bodily from some text-book 
— furnished by the nurse when the ques- 
tion of necessary preparation comes up 
Text-books serve a very useful purpose ; 



302 



THE TRAINED NURSE AND HOSPITAL REVIEW 



so, also, does common sense, and the 
most successful private nurses are, as it 
surely ought to be needless to urge, 
those who use the latter in conjunction 
with the former, and who will therefore 
be able to discriminate and know when 
a list entirely appropriate for the well- 
to-do or for the average patient who 
employs the services of a trr»ined nurse 
may need to be shorn of all but the 
barest necessities. Baby's wardrobe, 
mother's clothing and bed furnishings 
may generally be accepted ;is provided 
by the patient, who very probably has 
her individual ideas as to what is most 
desirable, and the nurse being concerned 
only if these are insuflficient to maintain 
cleanliness or of a nature to cause dis- 
comfort. The nurse should see that the 
necessary vaginal dressings ^ r pads arc 
provided and also that the bed pi^ds or 
other materials to be used for protection 
of patient's bed are in readiness for her 
illness. The most desirable vaginal pads 
are those made of absorbent cotton fold- 
ed inside hospital gauze, snflFicient thick- 
ness of cotton to absorb discharge and 
prevent soiling of bed should discharge 
be free ; and about five dozen are likely 
to be required in the avrage case. 
Cheesecloth may be used instead of hos- 
pital gauze, but cotton batting is a poor 
substitute for absorbent cotton. It is 
cheap, but a poor absorbent. When 
other more desirable materials are not 
available, a quantity of clean old white 
cotton or linen may be on hand — worn 
sheets, towels, pillow cases, etc. — and 
these (be sure that they have been well 
washed and boiled), when folded into 
pads, make a fairly satisfactory substi- 
tute, and one that, like the absorbent 
cotton, can be immediately burned when 
soiled. Besides the oilcloth, customarily 



provided for protection of patient's bed, 
three or four pads will be a great con- 
venience. One, for use at time of birth, 
should be large and thick ; others for 
later use may be smaller and thinner. 
Cotton batting laid between two layers 
of cheesecloth or old muslin, and then 
all loosely tucked together, is a common 
and satisfactory method of making bed 
pads, but they may be made of other 
materials if necessary. After vaginal 
pads are made they should be folded I 
and wrapped (some separately and oth- 
ers in twos and threes) in pieces of 
gauze, cheesecloth or old white muslin, 
and then very thoroughly sterilized be- 
fore being laid away in some clean box 
of drawer, where they will be undis- 
turbed beforehand and convenient when 
wanted. Bed pads should also be made 
into separate packages and sterilized, 
and there should also be provided and 
sterilized, ready for use, a T bandage 
(more than one may be required, but, 
if so, others can readily be made later) ; 
a straight strip of strong, unbleached 
muslin about fifteen or eighteen inches 
wide, to